Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. Electronic address: https://twitter.com/@ejfu0209.
Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. Electronic address: https://twitter.com/@pedro_cepas.
Rev Esp Cardiol (Engl Ed). 2023 Nov;76(11):881-890. doi: 10.1016/j.rec.2023.03.008. Epub 2023 Mar 22.
Data on the clinical profile and outcomes of younger patients with ST-elevation myocardial infarction (STEMI) is scarce. This study compared clinical characteristics and outcomes between patients aged<45 years and those aged ≥ 45 years with STEMI managed by the acute myocardial infarction code (AMI Code) network. Sex-based differences in the younger cohort were also analyzed.
This multicenter study collected individual data from the Catalonian AMI Code network. Between 2015 and 2020, we enrolled patients with an admission diagnosis of STEMI. Primary endpoints were all-cause mortality within 30 days, 1 year, and 2 years.
Overall, 18 933 patients (23% female) were enrolled. Of them, 1403 participants (7.4%) were aged<45 years. Younger patients with STEMI were more frequently smokers (P<.001) and presented with cardiac arrest and TIMI flow 0 before pPCI (P<.05), but the time from first medical contact to wire crossing was shorter than in the older group (P<.05). All-cause mortality rates were lower in patients aged<45 years (P<.001). Among younger patients, cardiogenic shock was most prevalent in women than in their male counterparts (P=.002), with the time from symptom onset to reperfusion being longer (P<.05). Compared with men aged<45 years, younger women were less likely to undergo pPCI (P=.004).
Despite showing high-risk features on admission, young patients exhibit better outcomes than older patients. Differences in ischemia times and treatment were observed between men and women.
关于年轻 ST 段抬高型心肌梗死（STEMI）患者的临床特征和结局的数据很少。本研究比较了通过急性心肌梗死代码（AMI 代码）网络管理的年龄<45 岁和年龄≥45 岁的 STEMI 患者的临床特征和结局。还分析了年轻队列中基于性别的差异。
这项多中心研究从加泰罗尼亚 AMI 代码网络中收集了个体数据。在 2015 年至 2020 年间，我们招募了入院诊断为 STEMI 的患者。主要终点是 30 天、1 年和 2 年的全因死亡率。
共有 18933 名患者（23%为女性）入组。其中，1403 名患者（7.4%）年龄<45 岁。年轻 STEMI 患者更频繁地吸烟（P<.001），并且在 pPCI 前出现心脏骤停和 TIMI 血流 0（P<.05），但从首次医疗接触到穿线的时间比老年组短（P<.05）。年轻患者的全因死亡率较低（P<.001）。在年轻患者中，心源性休克在女性中比在男性中更为常见（P=.002），并且从症状发作到再灌注的时间更长（P<.05）。与年龄<45 岁的男性相比，年轻女性接受 pPCI 的可能性较小（P=.004）。
尽管年轻患者入院时表现出高危特征，但他们的预后好于老年患者。在男性和女性之间观察到缺血时间和治疗的差异。
