Risk factors profile and angiographic characters of young adults presenting with ST-elevation acute myocardial infarction

Abstract

Objective: ST-elevation myocardial infarction is a disease of elderly; however, there is rising trend of
STEMI among youth who have unique characteristics. Aim of this study was to investigate risk profile and
angiographic findings in young Egyptians with STEMI as compared to elderly.
Methods: We studied 235 patients admitted to Ainshams university hospital with STEMI. They were
divided into 2 groups >40 and ≤40 years, risk profile and angiographic findings were further compared.
Results: Males were predominantly affected at young age. Smoking was prevalent in both groups. Elderly
had higher prevalence of diabetes (P<0.01), and hypercholesterolemia (P0.015), while young patients were
more likely to be drug addicts (P<0.001) and to have a family history of premature CAD (P<0.001).
Anterior STEMI was significantly higher in youth (P0.049) while inferior STEMI was higher in elderly
(P0.042). MINOCA was exclusively found in young group (P<0.0001). Culprit LAD lesion was higher in
the young group (P0.016). Independent predictors of STEMI in youth were drug addiction (OR 8.8,
P<0.0001) and family history of premature CAD (OR 12.4, P<0.0001).
Conclusion: STEMI in young Egyptians was predominantly observed in men, smoking was the most
common risk factor like in elderly, However Youth have unique risk profile and angiographic findings.
They tend to be drug addicts and to have positive family history of premature CAD with less diabetes or
hypercholesterolemia. They have less extensive CAD. Anterior STEMI was the most common presentation
and LAD was the most common culprit.