Key result
Non-traditional risk factors including HIV (OR 4.06; 95% CI 3.48-4.71), SLE (OR 2.12), and OSA (OR 1.16) were significantly associated with a higher risk of acute myocardial infarction in young adults.
Why the study?
Although most prevalent in the elderly, myocardial infarction also affects younger adults, prompting an investigation of baseline characteristics in young patients (<55 years) with MI.
Are non-traditional risk factors such as HIV, SLE, and OSA associated with an increased risk of acute myocardial infarction in young adults (<55 years)?
Cohort
Yes
Are non-traditional risk factors such as HIV, SLE, and OSA associated with an increased risk of acute myocardial infarction in young adults (<55 years)?
Odds Ratio: 4.06 (95% CI 3.48–4.71)
p-value: p=<0.001
Non-traditional risk factors such as HIV, SLE, and OSA are significantly associated with an increased risk of acute myocardial infarction in young adults (<55 years), highlighting the need for comprehensive risk assessment in this population.
May support expanded risk assessment in young adults; leaves open causal and interventional implications.
Although most prevalent in elderly, myocardial infarction (MI) also affects younger adults. We sought to investigate baseline characteristics in young patients (<55 years) with MI using the National Inpatient Sample (NIS) database between 2004 and 2015. Multivariable logistic regression models were used to assess factors associated with acute myocardial infarction (AMI) in young patients. After multivariable analyses adjusted for age, sex, race, family history of atherosclerosis, body mass index (BMI), diabetes, hypertension, hyperlipidemia, chronic kidney disease, and current cigarette smoking; novel risk factors such as human immunodeficiency virus (HIV), systemic lupus erythematosus (SLE), and obstructive sleep apnea (OSA) were associated with a higher risk of developing an AMI in the young (adjusted OR for HIV 4.06; 95 CI 3.48-4.71, p < 0.001), (adjusted OR for SLE 2.12; 95 CI 1.89-2.39, p 0.04), and (adjusted OR for OSA 1.16; 95 CI 1.12-1.20, p < 0.001), respectively. Rheumatoid arthritis was associated with a lower risk of AMI (adjusted OR 0.83; 95 CI 0.76-0.89, p < 0.001). After multivariable analyses, cigarette smoking (adjusted OR 1.98; 95 CI 1.95-2.02, p < 0.001), obesity (adjusted OR 1.37; 95 CI 1.33-1.41, p = 0.003), hyperlipidemia (adjusted OR 1.07; 95 CI 1.04-1.08, p < 0.001) and a family history of CAD (adjusted OR 1.35; 95 CI 1.3-1.4, p < 0.001) were also associated with a higher risk of developing an AMI in the young. In conclusion, young patients with AMI have both traditional risk factors and non-traditional risk factors. In addition to traditional risk factors, close attention should be paid to emerging risk factors such as SLE, HIV and OSA.
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Krittanawong et al. (2020) conducted a cohort in Acute myocardial infarction. Non-traditional risk factors (HIV, SLE, OSA) vs. Absence of these risk factors was evaluated on Acute myocardial infarction (AMI) (OR 4.06, 95% CI 3.48-4.71, p=<0.001). Non-traditional risk factors including HIV (OR 4.06; 95% CI 3.48-4.71), SLE (OR 2.12), and OSA (OR 1.16) were significantly associated with a higher risk of acute myocardial infarction in young adults.
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