From the Department of Cardiology (Sakr, Azazy, Hillani, Ebada, Alharbi, Algassim) King Saud Medical City; from the Department of Medicine (Algassim), King Saud Medical City; from the Department of Cardiology (Sakr), King Abdullah Bin Abdulaziz University Hospital; from the Department of Cardiology (Alshalash), King Fahad Medical City; form the Department of Medicine (Algassim), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia; from the Department of Cardiology (Hillani), University of Montreal Hospital Center, Montreal, Quebec; and from the Division of Nuclear Medicine (Abazid), London Health Sciences Centre, University Hospital, London, Ontario, Canada.
Saudi Med J. 2021 Nov;42(11):1201-1208. doi: 10.15537/smj.2021.42.11.20210412.
To investigate the clinical profiles and outcomes of young adults presenting with ST-segment elevation myocardial infarction (STEMI).
We retrospectively reviewed King Saud Medical City, Riyadh, Saudi Arabia, registry between January 2016 and November 2017 for all patients younger than 45 years old who were admitted with STEMI. We compared this study population to a control group of patients aged 45 years and older who were enrolled in the same period.
In total, 402 patients were enrolled; 197 were younger than 45 years. The incidence of newly diagnosed dyslipidemia was higher in younger patients (44% vs. 32%, =0.01). Smoking was significantly more prevalent in the younger group (52% vs. 35%, =0.001). The prevalence of pulmonary edema and cardiogenic shock on presentation was significantly higher in the older group (3% vs. 10; odds ratio, 4.43; 95% confidence interval, 1.750-10.94; =0.002). Hospital stay was also longer in the older group (4±2 vs. 5±2 days, =0.03).
ST-segment elevation myocardial infarction in young patients has a favorable outcome. Smoking and dyslipidemia are the main risk factors for STEMI in young individuals. The majority of young patients with dyslipidemia were not aware of their pre-existing condition. Our findings recommend local adaptation and implementation of screening programs for dyslipidemia in the young and the reinforcement of smoking prevention programs.
研究年轻成人 ST 段抬高型心肌梗死(STEMI)的临床特征和转归。
我们回顾性分析了 2016 年 1 月至 2017 年 11 月沙特阿拉伯利雅得 King Saud 医疗城的登记资料,纳入所有年龄小于 45 岁的 STEMI 患者。将该研究人群与同期年龄大于 45 岁的对照组患者进行比较。
共纳入 402 例患者,其中 197 例年龄小于 45 岁。新发血脂异常在年轻患者中更为常见(44%比 32%,=0.01)。年轻组吸烟更为常见(52%比 35%,=0.001)。老年组入院时肺水肿和心源性休克的发生率明显更高(3%比 10%;优势比,4.43;95%置信区间,1.750-10.94;=0.002)。老年组的住院时间也更长(4±2 比 5±2 天,=0.03)。
年轻患者的 STEMI 转归良好。吸烟和血脂异常是年轻个体发生 STEMI 的主要危险因素。大多数血脂异常的年轻患者并未意识到自己存在潜在疾病。我们的研究结果建议在年轻人中对血脂异常进行当地适应性筛查,并加强吸烟预防计划。