Young MI patients face similar mortality outcomes as older adults

Very young patients who experience myocardial infarction (MI) show similar 1-year and long-term outcomes as those aged 41–50 years at the time of their index infarction despite the former being 10 years younger, on average, and having a lower prevalence of hypertension, reveals a recent study.

“Despite significant progress in primary prevention, the rate of MI has not decreased in young adults,” the authors said.

This study compared the risk factor profiles and outcomes between individuals who experienced a first MI at a very young (≤40 years) and a young (age 41–50 years) age. They examined all patients aged ≤50 years admitted with a type 1 MI to two large academic hospitals from 2000 to 2016. Electronic medical records were reviewed to establish the risk factors. All-cause and cardiovascular mortalities were the primary outcomes.

A total of 2,097 consecutive young patients with MI were included, of whom 431 (20.5 percent) were aged ≤40 years. Very young patients had similar risk profiles when compared with their older counterparts, except for greater substance abuse (17.9 percent vs 9.3 percent; p<0.001) and less hypertension (37.9 percent vs 50.9 percent; p<0.001). Very young patients were also more likely to have spontaneous coronary artery dissection (3.1 percent vs 1.1 percent; p=0.003).

Over a median follow-up of 11.2 years, the risk of all-cause and cardiovascular mortality was similar between young and very young MI patients.

“Our findings suggest the need for aggressive secondary prevention measures in very young patients who experience MI,” the authors said.