Incidence, risk factors and outcome of young patients with myocardial infarction

Abstract

ObjectiveThe decline in the incidence and mortality of acute myocardial infarction (AMI) has been less among younger compared with older individuals. The aim of this nationwide study was to assess the current incidence, risk factors and outcome of AMI in patients <45 years of age.MethodsAll patients ≤80 years of age registered in the Norwegian Myocardial Infarction Register in 2013–2016 were included in this observational, nationwide cohort study. Follow-up was conducted through linkage with the Norwegian Patient Registry through 2017.ResultsAmong a total of 33 439 patients ≤80 years with AMI, 1468 (4.4%) were <45 years old. The incidence of AMI was 2.1 per 100 000 person-years in people aged 20–29 years, 16.9 in people aged 30–39 years and 97.6 in people aged 40–49 years. Compared with older patients, patients <45 years were more likely to be male (81%), current smokers (56%), obese (30%) and have a family history of premature AMI (44%), and their low-density lipoprotein-cholesterol levels were higher. Patients <45 years were more likely to have non-obstructive coronary artery disease (14% vs 10%, p<0.001) compared with older patients. During a median follow-up time of 2.4 years, 135 (9%) patients <45 years experienced a new AMI, stroke or death, and 58 (4%) patients died.ConclusionsThe rate of AMI was low in people <45 years old in Norway, but almost one in ten patients with AMI <45 years old died or experienced a new cardiovascular event during follow-up. Increased efforts to improve risk factor control in these patients are warranted.

Serum lipid abnormalities in migraine: A meta‐analysis of observational studies

“…The relationship between dyslipidemia and vascular risk is well‐recognized. It has been determined that patients <45 years with cardiovascular events have higher low‐density lipoprotein cholesterol (LDL‐C) than the respective group of patients >45 years (45–80 years) 17 . Additionally, vascular events in this age group (<45 years) have been linked to only mildly abnormal values of total cholesterol (TC), LDL‐C, high‐density lipoprotein cholesterol (HDL‐C), and triglycerides (TGs) in statin‐naïve adults 18 .…”

Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

“…Several traditional risk factors for coronary artery disease (CAD), which include current smoking status, elevated body mass index (BMI), and a family history of premature acute myocardial infarction (AMI), have been associated with younger age [3]. In addition, non-traditional risk factors, such as hyperhomocysteinemia (HHCY), have also been suggested as novel markers for CAD and are supposed to be added to Framingham Risk Factors (FRFs) to boost their predictive value [4,5].…”

Gender differences in clinical characteristics and in-hospital and one-year outcomes of young patients with ST-segment elevation myocardial infarction under the age of 40

“…In studies accepting the age limit as <40-45, the incidence of acute MI has been reported to be between 4-10%. 2,17 ın our study, among all patients who had acute STEMI 5.65% were in the age group of ≤ 40 years. Since the first definition of acute MI, different inclusion criteria have been used in different geographies and different populations, especially in the last 10 years.…”

“… 1 Although acute ST-segment elevation myocardial infarction (STEMI) is mainly seen in the elderly, 4-10% of patients with acute STEMI have been reported to be under the age of 45. 2 , 3 The incidence of STEMI in young individuals has been reported to be between 2-12% in different studies. This wide range of incidences depends on the use of different cut-off values ​​ranging from the age of 35-55 for the definition of ‘young’ in the studies.…”