Chachar Tarique S, Noor Husam A, AlAnsari Nouf F, Masood Abdulrahman, Alraee Abdulrahman, Amin Haitham, Yousif Nooraldaem
Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR.
Cardiology, Bahrain Defence Force Hospital, Awali, BHR.
Cureus. 2024 Feb 6;16(2):e53688. doi: 10.7759/cureus.53688. eCollection 2024 Feb.
Objective This study aimed to examine the clinical characteristics, risk factors, and outcomes of patients aged ≤45 years with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods From January 2018 to March 2020, this retrospective observational study took place at a tertiary cardiac center in Bahrain. We included patients aged ≤45 years who were admitted with STEMI and had primary percutaneous coronary intervention (pPCI). Results In this study, 510 patients with STEMI receiving pPCI were included, of whom 95 (18%) were younger than 45 years. The young age group had more smokers (57.9% vs. 40.5%, p = 0.003), newly diagnosed dyslipidemia (41.1% vs. 25.5%, p = 0.004), and a positive family history of early coronary artery disease (CAD) (14.7% vs. 4.3%, p = <0.001). Traditional cardiovascular risk factors, such as diabetes mellitus, systemic hypertension, and dyslipidemia, were significantly less common in young patients. Major adverse cardiovascular and cerebrovascular events (MACCE) were also significantly less common in young patients at the one-year follow-up (2.1 vs. 8.4%, p = 0.05). Conclusion Young patients with STEMI are more often smokers with undiagnosed dyslipidemia and have a family history of CAD. MACCE at one year is significantly lower as compared to older patients, but it is not negligible. Public health efforts are needed to reduce the prevalence of modifiable risk factors among the susceptible population.
目的 本研究旨在探讨年龄≤45岁的ST段抬高型心肌梗死（STEMI）患者接受直接经皮冠状动脉介入治疗（pPCI）的临床特征、危险因素及预后。方法 2018年1月至2020年3月，这项回顾性观察性研究在巴林的一家三级心脏中心进行。我们纳入了年龄≤45岁、因STEMI入院并接受直接经皮冠状动脉介入治疗（pPCI）的患者。结果 本研究共纳入510例接受pPCI的STEMI患者，其中95例（18%）年龄小于45岁。年轻组吸烟者更多（57.9%对40.5%，p = 0.003），新诊断的血脂异常患者更多（41.1%对25.5%，p = 0.004），且有早发冠状动脉疾病（CAD）家族史的患者更多（14.7%对4.3%，p = <0.001）。糖尿病、系统性高血压和血脂异常等传统心血管危险因素在年轻患者中明显较少见。在一年随访中，年轻患者发生主要不良心血管和脑血管事件（MACCE）的情况也明显较少见（2.1%对8.4%，p = 0.05）。结论 STEMI年轻患者更常为吸烟者，伴有未诊断的血脂异常，且有CAD家族史。与老年患者相比，年轻患者一年时的MACCE明显较低，但并非可以忽略不计。需要开展公共卫生工作以降低易感人群中可改变危险因素的患病率。
