Clinical Presentation and In-Hospital Outcomes of Acute Myocardial Infarction in Young Patients
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Key result
In young patients with acute myocardial infarction, concomitant cardiopulmonary arrest at presentation was strongly associated with increased in-hospital mortality (OR 14.2).
Why the study?
Risk factors and prognosis of acute myocardial infarction in young patients have yet to be fully characterized despite significant adverse health and social impacts.
Does younger age affect the clinical presentation and in-hospital mortality in patients undergoing primary PCI for acute myocardial infarction?
Population
213,297 patients aged 20 to 79 years with AMI undergoing primary PCI in Japan
Comparison
Younger patients (ages 20 to 49 years) vs older patients (ages 50 to 79 years)
Design
Retrospective nationwide registry-based cohort study
Authors
Discussion
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Member takes
Implication
CPA associated with 14-fold higher mortality in young AMI; hypothesis-generating for prevention strategies.
Study Design
Type
Cohort (n=213,297)
Multicenter
Yes
Structured PICO
Does younger age affect the clinical presentation and in-hospital mortality in patients undergoing primary PCI for acute myocardial infarction?
P
Population
213,297 patients aged 20 to 79 years with acute myocardial infarction who underwent primary percutaneous coronary intervention in Japan.
E
Exposure
Younger age (20 to 49 years) at the time of primary PCI for AMI
C
Comparator
Older age (50 to 79 years) at the time of primary PCI for AMI
O
Outcome
Presentation with cardiopulmonary arrest (CPA) and in-hospital mortality within 30 days after PCIhard clinical
Main Result
Odds Ratio: 14.2 (95% CI 9.2–21.9)
Absolute Event Rate: 14% vs 0.46%
p-value: p=<0.001
Despite having fewer traditional comorbidities, young patients with AMI have a higher risk of presenting with cardiopulmonary arrest, which dramatically increases their in-hospital mortality.
Limitations
- Only patients who underwent PCI were eligible for enrollment, potentially excluding critically ill patients who did not undergo PCI
- Lack of data on oral contraceptive use, drug abuse, and history of Kawasaki disease
- Lack of data on obesity and family history of premature AMI
- Potential sex-based differences in revascularization procedures
Cite This Study
Ando et al. (2022) conducted a cohort in Acute myocardial infarction (n=213,297). Cardiopulmonary arrest (CPA) at presentation vs. No cardiopulmonary arrest was evaluated on In-hospital mortality (OR 14.2, 95% CI 9.2-21.9, p=<0.001). In young patients with acute myocardial infarction, concomitant cardiopulmonary arrest at presentation was strongly associated with increased in-hospital mortality (OR 14.2).
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