Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
Am J Cardiol. 2019 Mar 15;123(6):889-893. doi: 10.1016/j.amjcard.2018.12.017. Epub 2018 Dec 20.
ST-elevation myocardial infarction (STEMI) in very young patients is an uncommon entity but with significant clinical meaning for the patient. These individuals may have different risk profiles and prognosis. Few reports have described epidemiology, clinical features, and long-term outcomes of these patients in the era of percutaneous coronary intervention, particularly of those ≤35. This observational study evaluates the clinical characteristics of patients <35 years with STEMI between January 2004 and September 2016 in 3 different centers. We gathered data and follow-up from the prospective database of the interventional cardiology department, medical history, and phone interviews. Over a total of 3,883 STEMI, we retrieved 61 patients ≤35. They were mainly male (88%), smokers (80%), and overweight (67%). Twenty-six percent were drug consumers. Only 2 patients (3%) were free of conventional risk factors. In-hospital mortality was 5% (3 deaths). They were followed-up for 5.9 ± 4.2 years with a total survival of 96.6% (2 deaths). Major adverse cardiovascular events incidence at the end of follow-up was only 17.2% (10 patients). STEMI in the young is a rare condition. These patients have several modifiable predisposing factors, a low clinical risk profile, and excellent short- and long-term prognosis with state-of-the-art treatment.
年轻患者的 ST 段抬高型心肌梗死(STEMI)并不常见,但对患者具有重要的临床意义。这些患者可能具有不同的风险状况和预后。很少有报告描述经皮冠状动脉介入治疗时代这些患者的流行病学、临床特征和长期结局,尤其是≤35 岁的患者。本观察性研究评估了 2004 年 1 月至 2016 年 9 月在 3 个不同中心的<35 岁 STEMI 患者的临床特征。我们从介入心脏病学部门的前瞻性数据库、病史和电话访谈中收集数据和随访信息。在总共 3883 例 STEMI 中,我们检索到≤35 岁的 61 例患者。他们主要为男性(88%)、吸烟者(80%)和超重者(67%)。26%的患者为药物使用者。仅有 2 例(3%)患者无常规危险因素。住院期间死亡率为 5%(3 例死亡)。他们接受了 5.9±4.2 年的随访,总生存率为 96.6%(2 例死亡)。随访结束时主要不良心血管事件发生率仅为 17.2%(10 例)。年轻患者的 STEMI 较为罕见。这些患者存在多种可改变的诱发因素,临床风险状况低,采用最新治疗后具有极好的短期和长期预后。