Young patients with acute myocardial infarction: early screening is warranted

Background Acute Myocardial Infarction (AMI) remains a significant cause of morbidity and mortality in young individuals, although relatively under-studied, with no consensus on a cutoff value for this definition. Purpose The purpose of this study was to compare the cardiovascular risk factors and characteristics of acute coronary events in a population of younger versus older AMI patients. Methods A retrospective analysis of consecutive AMI patients admitted to the Cardiology Department from November 2021 to October 2022 was conducted. The population was evaluated according to basal characteristics. We divided the population in two groups: young AMI patients (YAMI) (defined as ≤50 years) and older AMI patients (defined as >50 years), which were compared according to demographic and index-hospitalization variables, co-morbidities, analytical and echocardiographic data and adverse events. Results A total of 390 patients (71.3% males) with a mean age of 66.6 ± 12.3 years were included. The characteristics of the two groups are described in Table 1. The YAMI group (n=38) had a median age of 46.0 years (IQR 43-48) and 86.8% were male. In this group of patients, 42.1% had a known diagnosis of hypertension, 39.5% had dyslipidemia, 39.5% had type 2 diabetes, 26.3% were obese and 76.3% were smokers. ST-elevation myocardial infarction (STEMI) presentation occurred in 68.4% and multivessel disease was observed in 31.6% of the YAMI group. Patients in the YAMI group were predominantly male (p = 0.026), smokers (p < 0.001) and with a family history (FH) of AMI (p = 0.007). STEMI was more likely in the YAMI group (p = 0.007), which had higher LDL-cholesterol (p = 0.007) and total cholesterol levels (p = 0.003), but lower glycosylated hemoglobin values (p = 0.005). Conclusion This study emphasizes that YAMI patients in this population exhibit greater metabolic dysregulation, evidenced by higher LDL, and total cholesterol levels, highlighting the importance of early screening and intervention in younger patients with cardiovascular risk factors (namely smokers) and with a family history of AMI.