Characteristics and outcomes of young patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: retrospective analysis in a multiethnic Asian population

Abstract

ObjectiveST segment elevation myocardial infarction (STEMI) is associated with significant mortality leading to loss of productive life years, especially in younger patients. This study aims to compare the characteristics and outcomes of young versus older patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) to help focus public health efforts in STEMI prevention.MethodsData from the Coronary Care Unit database of the National University Hospital, Singapore from July 2015 to June 2019 were reviewed. Patients were divided into young (<50 years old) or older (≥50 years old) groups.ResultsOf the 1818 consecutive patients with STEMI who underwent PPCI, 465 (25.6%) were <50 years old. Young compared with older patients were more likely to be male, current smokers, of Indian ethnicity, have family history of ischaemic heart disease (IHD) and had lower 1 year mortality (3.4% vs 10.4%, p<0.0001). Although diabetes, hypertension or dyslipidaemia was less common among young patients, the prevalence of having any one of these risk factors was high in the range of 28% to 38%. Age was an independent predictor of mortality in the older but not younger patients with STEMI, and diabetes showed a trend towards mortality in both groups.ConclusionYoung patients with STEMI are more often smokers, of Indian ethnicity and had family history of IHD, although cardiometabolic risk factors are also prevalent. Mortality is lower, but not negligible, among the young patients with STEMI. Public health efforts are needed to reduce the prevalence of these risk factors among the constitutionally susceptible population.

One-year outcomes of patients with ST-segment elevation myocardial infarction during the COVID-19 pandemic

“…This is a retrospective single-centre cohort study of patients who presented to a major percutaneous coronary intervention (PCI) capable hospital in Singapore, with STEMI and underwent primary PCI. This hospital is part of the Western STEMI network, which provides PCI services to the western region of Singapore [10]. The Western STEMI network is a hub-and-spoke system that consists of our hospital (hub) as well as two other spoke hospitals.…”

“…Data on demographic and clinical characteristics were obtained from the ongoing hospital STEMI care database [10]. This included previous medical history, clinical status at index presentation and medications on discharge.…”

ST-Elevation Acute Myocardial Infarction in a Young Man

“…Worldwide cardiovascular disease mortality is increasing, and onset age is gradually dropping [ 9 ]. STEMI is associated with significant mortality, which leads to a loss of productive years of life, particularly in younger patients [ 11 ]. In younger patients with STEMI, the mortality rate is lower, but not negligible [ 11 ].…”

“…STEMI is associated with significant mortality, which leads to a loss of productive years of life, particularly in younger patients [ 11 ]. In younger patients with STEMI, the mortality rate is lower, but not negligible [ 11 ]. Young patients also experience higher rates of cardiogenic shock, out-of-hospital cardiac arrest, and STEMI [ 27 ].…”

Acute Myocardial Infarction in Young Men Under 50 Years of Age: Clinical Characteristics, Treatment, and Long-Term Prognosis

“…In line with previous findings, the young were more frequently to have the single-vessel occlusion. 27,28 There was an increasing tendency of diseased vessels with increasing age. 29 One explanation is the multi-vessel disease occurred more commonly in individuals who have a history of diabetes.…”