TY - JOUR
T1 - Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction
T2 - The Partners YOUNG-MI Registry
AU - Yang, Junjie
AU - Biery, David W.
AU - Singh, Avinainder
AU - Divakaran, Sanjay
AU - DeFilippis, Ersilia M.
AU - Wu, Wanda Y.
AU - Klein, Josh
AU - Hainer, Jon
AU - Ramsis, Mattheus
AU - Natarajan, Pradeep
AU - Januzzi, James L.
AU - Nasir, Khurram
AU - Bhatt, Deepak L.
AU - Di Carli, Marcelo F.
AU - Blankstein, Ron
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/5
Y1 - 2020/5
N2 - BACKGROUND: Despite significant progress in primary prevention, the rate of myocardial infarction has not decreased in young adults. We sought to compare the risk factor profiles and outcomes between individuals who experienced a first myocardial infarction at a very young (≤40 years) and a young (age 41-50 years) age.METHODS: We evaluated all patients ≤50 years of age admitted with a Type 1 myocardial infarction to 2 large academic hospitals from 2000 to 2016. Risk factors were determined by review of electronic medical records. The primary outcomes of interest were all-cause and cardiovascular mortality.RESULTS: Among 2097 consecutive young patients with myocardial infarction, 431 (20.5%) were ≤40 years of age. When compared with their older counterparts, very young patients had similar risk profiles, with the exception of greater substance abuse (17.9% vs 9.3%, P < .001) and less hypertension (37.9% vs 50.9%, P < .001). Spontaneous coronary artery dissection was more prevalent in very young patients (3.1% vs 1.1%, P = .003). Over a median follow-up of 11.2 years, very young myocardial infarction patients had a similar risk of all-cause and cardiovascular mortality.CONCLUSIONS: Despite being, on average, 10 years younger and having a lower prevalence of hypertension, very young myocardial infarction patients had similar 1-year and long-term outcomes when compared with those aged 41 to 50 years at the time of their index infarction. Our findings suggest the need for aggressive secondary prevention measures in very young patients who experience a myocardial infarction.
AB - BACKGROUND: Despite significant progress in primary prevention, the rate of myocardial infarction has not decreased in young adults. We sought to compare the risk factor profiles and outcomes between individuals who experienced a first myocardial infarction at a very young (≤40 years) and a young (age 41-50 years) age.METHODS: We evaluated all patients ≤50 years of age admitted with a Type 1 myocardial infarction to 2 large academic hospitals from 2000 to 2016. Risk factors were determined by review of electronic medical records. The primary outcomes of interest were all-cause and cardiovascular mortality.RESULTS: Among 2097 consecutive young patients with myocardial infarction, 431 (20.5%) were ≤40 years of age. When compared with their older counterparts, very young patients had similar risk profiles, with the exception of greater substance abuse (17.9% vs 9.3%, P < .001) and less hypertension (37.9% vs 50.9%, P < .001). Spontaneous coronary artery dissection was more prevalent in very young patients (3.1% vs 1.1%, P = .003). Over a median follow-up of 11.2 years, very young myocardial infarction patients had a similar risk of all-cause and cardiovascular mortality.CONCLUSIONS: Despite being, on average, 10 years younger and having a lower prevalence of hypertension, very young myocardial infarction patients had similar 1-year and long-term outcomes when compared with those aged 41 to 50 years at the time of their index infarction. Our findings suggest the need for aggressive secondary prevention measures in very young patients who experience a myocardial infarction.
KW - Premature coronary artery disease
KW - Risk factors
KW - Very young adults
KW - Age Factors
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Kaplan-Meier Estimate
KW - Male
KW - Treatment Outcome
KW - Coronary Angiography
KW - Myocardial Infarction/etiology
KW - Adult
KW - Coronary Disease/diagnostic imaging
KW - Female
KW - Registries
KW - Retrospective Studies
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U2 - 10.1016/j.amjmed.2019.10.020
DO - 10.1016/j.amjmed.2019.10.020
M3 - Article
C2 - 31715169
AN - SCOPUS:85077151998
SN - 0002-9343
VL - 133
SP - 605-612.e1
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 5
ER -