Risk profile and prognosis of myocardial infarction in young adults: a comparative study

Myocardial infarction in young adults is increasingly recognised as a distinct clinical entity, with limited data from North African populations. This study aimed to compare risk profiles and outcomes of ST-segment elevation myocardial infarction (STEMI) between young and older patients. Methods We conducted a retrospective comparative study including patients who experienced a first STEMI. Patients were stratified into two groups based on an age of 50 years. All data were analysed from medical records, and follow-up was a minimum of 12 months. The primary endpoint was cardiovascular mortality, and the secondary endpoint included a composite of non-fatal myocardial infarction, hospitalisation for acute heart failure and stent thrombosis or restenosis. Results Among 206 patients included, younger patients had higher rates of smoking (84.9% vs 60%, p < 0.05), chronic heavy alcohol use (30.2% vs 7%, p < 0.05) and family history of coronary artery disease (22.6% vs 7%, p < 0.05). Cardiovascular mortality was higher in older patients (11% vs 0.9%, p < 0.01), whereas the incidence of cardiovascular events was similar between the two groups (25.5% vs 26%, p = 0.96). Conclusion Young STEMI patients have a significant risk of adverse outcomes despite distinct risk profiles, warranting targeted strategies.