title: Short and long-term survival after primary percutaneous coronary intervention in young patients with ST-elevation myocardial infarction.
abstract: The long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) aged 45 years or younger and differences according to gender have not been well characterized.
  
  
  METHODS
  We included 16,685 consecutive STEMI patients from 2003 to 2012 (67,992 patient-years follow-up) from the Eastern Danish Heart Registry and the Swedish Coronary Angiography and Angioplasty Registry who were treated with primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  We identified 1026 (6.2%) patients up to 45 years of age (mean age: 40.7 vs. 66.3 years, P<0.001). Patients in the young group were predominantly men (79.7% vs. 71.9%) and smokers (71.2% vs. 44.2%, P<0.001) but with a lower prevalence of hypertension (17.3% vs. 39.3%), hyperlipidemia (18.0% vs. 23.8%), diabetes (9.0% vs. 12.4%) and previous myocardial infarction (6.9% vs. 12.2%, all P<0.001) compared with older patients. Young patients had a 0.8% annual mortality. During the follow-up period 6.3% of young patients died vs. 28.5% of older patients (P<0.001). Both 30-day-mortality (adjusted hazard ratio [HR]=0.26, 95% confidence interval [CI]: 0.12-0.54, P<0.001) and mortality after 30 days and onwards (HR=0.25, CI: 0.17-0.37, P<0.001) were significantly lower in the young group. There was no difference in short-term (HR=0.78, CI: 0.32-1.90, P=0.59) or long-term (HR=0.62, CI: 0.33-1.91, P=0.59) mortality between women and men in the young group (HR=0.79, CI: 0.21-1.80, P=0.39).
  
  
  CONCLUSIONS
  STEMI patients, aged 45 years or younger, have an excellent prognosis after treatment with primary PCI. Long-term annual survival is more than 99% in these patients. Young women with STEMI do not have a worse long-term prognosis than young men with STEMI.
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: homa_waziri@hotmail.com.
authors.forename: Homa
authors.initials: H
authors.lastname: Waziri
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.affiliation: Department of Cardiology, Skåne University Hospital, Malmö, Lund University, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Stagmo
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Frants
authors.initials: F
authors.lastname: Pedersen
authors.affiliation: Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
authors.affiliation: Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: James
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden; Glostrup University Hospital, Glostrup, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
mesh_terms: D000328:Adult; D002423:Cause of Death / Q000639:trends; D017023:Coronary Angiography; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
keywords: Long-term mortality; Percutaneous coronary intervention; ST-segment elevation myocardial infarction; Young patients