Samir Ahmad, Almahjori Mohammed, Zarif Basem, Elshinawi Mai, Yehia Hesham, Elhafy Mohamed, Shehata Ahmed, Farrag Azza
Faculty of Medicine, Cairo University, Cairo, Egypt.
National Heart Institute, Cairo, Egypt.
Egypt Heart J. 2023 Apr 25;75(1):32. doi: 10.1186/s43044-023-00357-2.
Coronary artery disease (CAD) is the commonest cause of death worldwide. ST-segment elevation myocardial infarction (STEMI) and its consequences can be devastating particularly at younger age for a bigger impact on the patient's psychology and ability to work. Little is known about the differential features and outcomes of young STEMI patients in Egypt. This study characterized young STEMI patients (≤ 45 years) compared to patients > 45 years and evaluated 1-year outcomes.
A total of 492 eligible STEMI patients who presented to the National Heart Institute and Cairo University Hospitals were recruited. Young STEMI patients (< 45 years old) represented 20% of all STEMI comers. Male gender was predominant in both groups, yet with a significantly higher proportion in the younger compared to older patients (87% vs. 73%, p = 0.004). Compared to older patients, young STEMI patients had characteristically higher rates of smoking (72.4% vs. 49.7%, p < 0.001) and family history (13.3% vs. 4.8%, p = 0.002), while significantly lower rate of other conventional CAD risk factors as diabetes, hypertension, and dyslipidemia (20.4% vs. 44.7%, 20.4% vs. 44.9% and 12.7% vs. 21.8%, respectively, p < 0.05 for all). Follow-up was continued for at least 12 months after the index event. Younger STEMI patients had fewer major adverse cardiovascular events and fewer heart failure hospitalizations compared to the older controls (10.2 vs. 23.9% and 18.4% vs. 34.8%, respectively, p < 0.005 for both), however, 1-year mortality was similar (3.1% vs. 4.1%, p = 0.64).
Younger STEMI patients (≤ 45 years) show peculiar characteristics, with significantly higher rates of smoking and family history of premature CAD, while less prevalence of other conventional CAD risk factors. Overall MACE occurred less in younger STEMI patients; however, the mortality rate was similar to the older controls.
冠状动脉疾病（CAD）是全球最常见的死亡原因。ST段抬高型心肌梗死（STEMI）及其后果可能是毁灭性的，尤其是在较年轻的患者中，对其心理和工作能力会产生更大影响。关于埃及年轻STEMI患者的差异特征和预后知之甚少。本研究对年轻STEMI患者（≤45岁）与年龄大于45岁的患者进行了特征描述，并评估了1年的预后情况。
共招募了492例符合条件的STEMI患者，这些患者均在国家心脏研究所和开罗大学医院就诊。年轻STEMI患者（<45岁）占所有STEMI患者的20%。两组中男性均占主导，但年轻患者中的比例显著高于老年患者（87%对73%，p = 0.004）。与老年患者相比，年轻STEMI患者的吸烟率（72.4%对49.7%，p < 0.001）和家族病史（13.3%对4.8%，p = 0.002）特征性地更高，而其他传统CAD危险因素如糖尿病、高血压和血脂异常的发生率则显著更低（分别为20.4%对44.7%、20.4%对44.9%和12.7%对21.8%，所有p < 0.05）。在索引事件后持续随访至少12个月。与老年对照组相比，年轻STEMI患者的主要不良心血管事件和心力衰竭住院次数更少（分别为10.2%对23.9%和18.4%对34.8%，两者p < 0.005），然而，1年死亡率相似（3.1%对4.1%，p = 0.64）。
年轻STEMI患者（≤45岁）表现出特殊特征，吸烟率和CAD早发家族史显著更高，而其他传统CAD危险因素的患病率更低。总体而言，年轻STEMI患者发生主要不良心血管事件较少；然而，死亡率与老年对照组相似。
