title: Acute ST-segment elevation myocardial infarction in young adults: who is at risk?
abstract: OBJECTIVE
  Less than 10% of patients presenting with acute myocardial infarction (AMI) are young adults. The primary objective of this study was to provide an overview of similarities and dissimilarities among younger and older patients presenting with AMI with the expectation of using the information as an aid in primary and secondary preventions in the future.
  
  
  METHODS
  From the database of 3527 patients with AMI admitted from January 2001 to December 2008, young adults aged 21-40 years (n = 43) who were diagnosed with ST-segment elevation myocardial infarction were identified. They were then compared with their older counterparts who were admitted from January 2007 to December 2008 subdivided into age groups of 41-60 (n = 86) and 61-80 years (n = 51). Data on clinical cardiovascular risk factors, demographic features, and angiographic findings were gathered and analyzed.
  
  
  RESULTS
  Only 2.58% of ST-segment elevation myocardial infarction patients who were admitted to our hospital over an 8-year period were less than 40 years. Young adults were found to be predominantly male patients (P = 0.04) and had positive family history for coronary artery disease (P = 0.0005). Diabetes and hypertension were less prevalent in the younger group (P = 0.048 and 0.078). Analysis of lipid profile showed comparatively higher total cholesterol, low-density lipoprotein and high-density lipoprotein values in the younger group (≤ P = 0.004). Angiographically, youngsters had propensity toward single-vessel involvement (P = 0.0001).
  
  
  CONCLUSIONS
  The risk factor profile and the angiographic involvement differ considerably in the high-risk younger adults and substantiate the need for an aggressive approach directed toward primary and secondary preventions of premature cardiovascular disease.
authors.affiliation: Department of Internal Medicine, St Joseph's Regional Medical Center, Paterson, New Jersey 07503, USA.
authors.forename: Sharad
authors.initials: S
authors.lastname: Bajaj
authors.forename: Fayez
authors.initials: F
authors.lastname: Shamoon
authors.forename: Nishant
authors.initials: N
authors.lastname: Gupta
authors.forename: Rupen
authors.initials: R
authors.lastname: Parikh
authors.forename: Neil
authors.initials: N
authors.lastname: Parikh
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Debari
authors.forename: Aiman
authors.initials: A
authors.lastname: Hamdan
authors.forename: Mahesh
authors.initials: M
authors.lastname: Bikkina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D008055:Lipids; D002784:Cholesterol