Elucidating the Clinical Outcomes of Very Young (<30 Years) Asian Indians Presenting with ST-elevation Myocardial Infarction – The ETUDES Study

A BSTRACT Background: There is a paucity of data regarding the clinical profile and outcomes of premature coronary artery disease, especially among Asian Indians. Methods: The ETUDES study was a prospective observational study that included 110 consecutive ST-elevation myocardial infarction (STEMI) patients aged <30 years (group A). Clinical and angiographic profiles were compared with age-matched normal coronaries patients (control group B, n = 42) and patients with STEMI >30 years of age (control group C, n = 300) and analyzed for conventional, unconventional risk factors and 3-point (Repeat myocardial infarction [Re-MI], stroke, and mortality) and 4-point MACE (Re-MI, stroke, HFH, and mortality). Results: Tobacco consumption was more prevalent in group A (53.64% vs. 11.9% vs. 37%) as compared to groups B ( P < 0.0001) and C ( P = 0.003), respectively. Alcohol consumption was prevalent in group A compared to C (13.64% vs. 0.67%; P < 0.0001). Dietary habits of eating outside and skipping breakfast (49.09% vs. 30.95% vs. 9%) were higher in group A ( P < 0.0001). Snoring (47.3% vs. 14%; P < 0.0001) and stress (28.18% vs. 10%; P = 0.003) were also higher in group A compared to group C. On regression analysis, odds of smoking odds ratio (OR) = 3.82 (1.98–14.90), habits of eating outside and skipping breakfast OR = 4.39 (2.27–8.49), and snoring OR = 2.05 ( P = 1.12–3.76) were found significant predictors of STEMI in < 30 years’ age. The MACE was found insignificant between groups A and C. Conclusion: Our findings indicate a higher prevalence of risk factors such as tobacco consumption, frequent eating out, and snoring among patients experiencing STEMI at very young. Very young acute myocardial infarction patients had rates of major adverse cardiovascular events (MACE) similar to other groups studied.