Clinical risk factors,angiographic findings and prognosis in young adults with ST-segment elevation myocardial infarction

Objective To evaluate the clinical characteristics,risk factors,angiographic features,and in-hospital and long-term outcomes in young patients(≤40 years) with ST-segment elevation myocardial infarction(STEMI).Methods From May 2005 to May 2010,the patients with STEMI underwent primary percutaneous coronary intervention(PCI) in our hospital and were enrolled in this retrospective study.These patients were divided into young adult group(40 years or below),middle age group(41-59 years) and elderly group(≥60 years).Clinical cardiovascular risk factors,angiographic findings,PCI outcomes and prognosis during 12-month follow up were analyzed.Results During the 5-year period,2.2% of STEMI patients admitted to our hospital for PCI were 40 years or below.95.0% of these young patients were male.Smoking rate in the young adult group was significantly higher than that in the elderly group(85.0% vs.64.8%,P0.05).Compared with the middle age group and elderly group,positive family history for coronary artery disease was more prevalent in the young adult group(P0.05).Incidence of single vessel lesion in the young adult group was significantly higher than that in the middle age group and the elderly group(65.0%,24.8%,20.6%,P0.05),especially left anterior descending branch(70.0%,57.5%,45.1%,P0.05).There were no significant differences in PCI success rate and case fatality among groups(P0.05).The incidence of severe heart failure in the young adult group was significantly lower than that in the elderly group in hospital and 12 months after PCI.The incidence of major adverse cardiovascular event(MACE) in the young adult group was significantly lower than that in the middle age group and elderly group 12 months after PCI(P0.05).Conclusion There are significant differences in features of risk factors and coronary artery lesions and prognosis between young adults and the elderly with myocardial infarction.Young adults who under going primary PCI have favorable long-term outcomes,such as recovery of cardiac function and MACE.