What is the clinical evidence from this study?

Study design: Observational. Population: ST-segment elevation myocardial infarction (STEMI) (n=402). Intervention: Young age (<45 years) vs. Older age (≥45 years). Primary outcome: Pulmonary edema and cardiogenic shock on presentation (OR 4.43, 95% CI 1.750-10.94, p=0.002).

November 1, 2021Open Access

Clinical profiles and outcomes of acute ST-segment elevation myocardial infarction in young adults in a tertiary care center in Saudi Arabia

Q: What are the key findings of this study?

Young adults (<45 years) presenting with STEMI had a significantly lower prevalence of pulmonary edema and cardiogenic shock compared to older patients (3% vs. 10%, OR 4.43).

Key Result

Young adults (<45 years) presenting with STEMI had a significantly lower prevalence of pulmonary edema and cardiogenic shock compared to older patients (3% vs. 10%, OR 4.43).

Study Design

Type

Observational (n=402)

Multicenter

Structured PICO

What are the clinical profiles and outcomes of young adults (<45 years) presenting with STEMI compared to older adults?

Population

402 patients admitted with ST-segment elevation myocardial infarction, comparing those younger than 45 years to those 45 years and older to evaluate clinical profiles and in-hospital outcomes.

Comparator

Patients aged 45 years and older admitted with STEMI during the same period.

Outcome

Clinical profiles and outcomes

Young adults with STEMI have favorable outcomes, but high rates of smoking and undiagnosed dyslipidemia highlight the need for targeted screening and prevention programs.

Main Result

Odds Ratio: 4.43 (95% CI 1.75–10.94)

Absolute Event Rate: 3% vs 10%

p-value: p=0.002

Limitations

Single-center, retrospective case-control analysis
Missing data for newly-diagnosed diabetes and hypertension in some patients
Missing angiographic data regarding the number of vessels involved and stents deployed for some patients
Lack of long-term follow-up data for all-cause mortality, re-hospitalization, recurrent AMI, and stroke
Relatively small sample size precluding calculation of true prevalence and incidence

Abstract

OBJECTIVES: To investigate the clinical profiles and outcomes of young adults presenting with ST-segment elevation myocardial infarction (STEMI). METHODS: We retrospectively reviewed King Saud Medical City, Riyadh, Saudi Arabia, registry between January 2016 and November 2017 for all patients younger than 45 years old who were admitted with STEMI. We compared this study population to a control group of patients aged 45 years and older who were enrolled in the same period. RESULTS: =0.03). CONCLUSION: ST-segment elevation myocardial infarction in young patients has a favorable outcome. Smoking and dyslipidemia are the main risk factors for STEMI in young individuals. The majority of young patients with dyslipidemia were not aware of their pre-existing condition. Our findings recommend local adaptation and implementation of screening programs for dyslipidemia in the young and the reinforcement of smoking prevention programs.

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