Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry

Junjie Yang; David W. Biery; Avinainder Singh; Sanjay Divakaran; Ersilia M. DeFilippis; Wanda Y. Wu; Josh Klein; Jon Hainer; Mattheus Ramsis; Pradeep Natarajan; James L. Januzzi; Khurram Nasir; Deepak L. Bhatt; Marcelo F. Di Carli; Ron Blankstein

doi:10.1016/j.amjmed.2019.10.020

Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry

Junjie Yang, David W. Biery, Avinainder Singh, Sanjay Divakaran, Ersilia M. DeFilippis, Wanda Y. Wu, Josh Klein, Jon Hainer, Mattheus Ramsis, Pradeep Natarajan, James L. Januzzi, Khurram Nasir, Deepak L. Bhatt, Marcelo F. Di Carli, Ron Blankstein

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Abstract

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.

Original language	English (US)
Pages (from-to)	605-612.e1
Journal	American Journal of Medicine
Volume	133
Issue number	5
DOIs	https://doi.org/10.1016/j.amjmed.2019.10.020
State	Published - May 2020

Keywords

Premature coronary artery disease
Risk factors
Very young adults
Age Factors
Humans
Middle Aged
Risk Factors
Kaplan-Meier Estimate
Male
Treatment Outcome
Coronary Angiography
Myocardial Infarction/etiology
Adult
Coronary Disease/diagnostic imaging
Female
Registries
Retrospective Studies

ASJC Scopus subject areas

General Medicine

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10.1016/j.amjmed.2019.10.020

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Yang, J., Biery, D. W., Singh, A., Divakaran, S., DeFilippis, E. M., Wu, W. Y., Klein, J., Hainer, J., Ramsis, M., Natarajan, P., Januzzi, J. L., Nasir, K., Bhatt, D. L., Di Carli, M. F., & Blankstein, R. (2020). Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry. American Journal of Medicine, 133(5), 605-612.e1. https://doi.org/10.1016/j.amjmed.2019.10.020

Yang, J, Biery, DW, Singh, A, Divakaran, S, DeFilippis, EM, Wu, WY, Klein, J, Hainer, J, Ramsis, M, Natarajan, P, Januzzi, JL, Nasir, K, Bhatt, DL, Di Carli, MF & Blankstein, R 2020, 'Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry', American Journal of Medicine, vol. 133, no. 5, pp. 605-612.e1. https://doi.org/10.1016/j.amjmed.2019.10.020

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title = "Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry",

abstract = "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.",

keywords = "Premature coronary artery disease, Risk factors, Very young adults, Age Factors, Humans, Middle Aged, Risk Factors, Kaplan-Meier Estimate, Male, Treatment Outcome, Coronary Angiography, Myocardial Infarction/etiology, Adult, Coronary Disease/diagnostic imaging, Female, Registries, Retrospective Studies",

author = "Junjie Yang and Biery, {David W.} and Avinainder Singh and Sanjay Divakaran and DeFilippis, {Ersilia M.} and Wu, {Wanda Y.} and Josh Klein and Jon Hainer and Mattheus Ramsis and Pradeep Natarajan and Januzzi, {James L.} and Khurram Nasir and Bhatt, {Deepak L.} and {Di Carli}, {Marcelo F.} and Ron Blankstein",

note = "Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",

year = "2020",

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doi = "10.1016/j.amjmed.2019.10.020",

language = "English (US)",

volume = "133",

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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

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.

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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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ER -

Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry

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Keywords

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