Abstract 11756: St-segment Elevation Myocardial Infarction in Young Patients - Analysis of Age Specific Risk Factors and Outcome-parameters
Introduction: ST-segment elevation myocardial infarction (STEMI) is relative rare in a population younger than 45years(y45). Despite the socio-economic impact, the specific risk factor (RF) profile in Y45 has been less studied as compared to older patients(pts).
Hypothesis: This study compared STEMI pts in terms of age specific RF, severity of myocardial infarction (MI) and outcomes between 2006 and 2014.
Methods: The Bremen heart center is exclusively responsible for emergency PCI in a metropolitan region of about 1 million inhabitants. Since 2006 all consecutive pts with STEMI were included in the Bremen Heart Registry.
Results: Of the 6329 included pts 450 (7%) were y45. Young pts were significantly often active smokers (85 vs 40%, p<0.01), characterized by a positive family history (FH) for cardiovascular disease (CVD) (44 vs 21%, p<0.01) and obesity (body mass index >30kg/m2: 29 vs 24%, p=0.04). These results were confirmed in a multivariate logistic regression model (table). While the number of young active smokers per year was constant (2006-09: 85% vs 81% in 2010-14, p=0.1), the proportion of obese pts increased significantly over time (2006-09:23% vs 36% in 2010-14, p<0.01). Y45 more often suffer larger MI (creatin kinase >3.000U/l: OR 1.7, 95% CI 1.3-2.1) and require prehospital resuscitation (OR 1.6, 95% CI 1.2-2.2). Despite these facts 30 day mortality (30dm) (2.4 vs 11.1%, p<0.01) and 1year mortality (1ym) (3.6 vs 14.5%, p<0.01) was significantly lower in y45.
Conclusions: The results of this large registry-study demonstrate that STEMI in y45 is characterized by more extensive MI and higher rates of pre-hospital resuscitation events. Nether the less the 30dm and 1ym is significantly lower than in older pts. The dominating RF in young STEMI pts was active smoking (85%), followed by a positive FH and obesity. To optimize prevention strategies further investigations have to be enforced elucidating specific genetic determinants of CVD in young pts.
Author Disclosures: A. Fach: None. J. Schmucker: None. L.A. Mata Marin: None. H. Wienbergen: None. S. Bünger: None. P. Conradi: None. E. Fiehn: None. R. Hambrecht: None.
- © 2015 by American Heart Association, Inc.