Key result
Age ≤45 years linked to ~75% lower 1-year MACCE after primary PCI for STEMI.
Why the study?
Clinical characteristics, risk factors, and outcomes of STEMI in patients aged 45 years or younger treated with pPCI were not well described.
Does young age (≤45 years) affect clinical characteristics, risk factors, and one-year MACCE in patients undergoing pPCI for STEMI?
Cohort (n=510)
No
Does young age (≤45 years) affect clinical characteristics, risk factors, and one-year MACCE in patients undergoing pPCI for STEMI?
Absolute Event Rate: 2.1% vs 8.4%
p-value: p=0.05
Young STEMI patients undergoing pPCI have distinct risk profiles, including higher rates of smoking and undiagnosed dyslipidemia, but experience lower 1-year MACCE compared to older patients.
Young STEMI patients warrant standard secondary prevention despite lower MACCE; leaves open age-specific risk modification trials.
Objective This study aimed to examine the clinical characteristics, risk factors, and outcomes of patients aged ≤45 years with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods From January 2018 to March 2020, this retrospective observational study took place at a tertiary cardiac center in Bahrain. We included patients aged ≤45 years who were admitted with STEMI and had primary percutaneous coronary intervention (pPCI). Results In this study, 510 patients with STEMI receiving pPCI were included, of whom 95 (18%) were younger than 45 years. The young age group had more smokers (57.9% vs. 40.5%, p = 0.003), newly diagnosed dyslipidemia (41.1% vs. 25.5%, p = 0.004), and a positive family history of early coronary artery disease (CAD) (14.7% vs. 4.3%, p = <0.001). Traditional cardiovascular risk factors, such as diabetes mellitus, systemic hypertension, and dyslipidemia, were significantly less common in young patients. Major adverse cardiovascular and cerebrovascular events (MACCE) were also significantly less common in young patients at the one-year follow-up (2.1 vs. 8.4%, p = 0.05). Conclusion Young patients with STEMI are more often smokers with undiagnosed dyslipidemia and have a family history of CAD. MACCE at one year is significantly lower as compared to older patients, but it is not negligible. Public health efforts are needed to reduce the prevalence of modifiable risk factors among the susceptible population.
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Chachar et al. (2024) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=510). Young age (≤45 years) vs. Older age (>45 years) was evaluated on Major adverse cardiovascular and cerebrovascular events (MACCE) at 1 year (p=0.05). Young patients (≤45 years) with STEMI undergoing primary PCI had a significantly lower rate of major adverse cardiovascular and cerebrovascular events at one year compared to older patients (2.1% vs. 8.4%, p=0.05).
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