Influence of Clinical, Angiographic, and Developmental Characteristics and COVID-19 Severity and Vaccination Status on Young Patients with Acute Myocardial Infarction

Abstract

ABSTRACT Background: Atherosclerosis is the most common cause of ischemic cardiovascular disease (CVD). However, approximately 20%–40% of cases of acute myocardial infarction (AMI) in patients aged <50 years can be attributed to genetic factors, and coronavirus disease 2019 (COVID-19) is a risk factor for blood clots and AMI. We aimed to describe the clinical, angiographic, and developmental characteristics and COVID-19 severity and vaccination status in patients aged ≤45 years with AMI. Methods: We retrospectively analyzed 2624 patients with AMI by reviewing the results of coronary angiography and percutaneous coronary intervention and medical reports. The study included patients aged >18 years who met the universal definition of AMI but excluded those with missing medical records or coronary angiograms. Results: In total, 2624 patients with AMI (aged 18–85 years) were included in the study and divided into two groups based on age: ≤45 (n = 1286) and >45 years (n = 1338). Total cholesterol and triglyceride levels were significantly higher in patients aged ≤45 years (5.6 ± 2.1 and 3.2 ± 2.1 mmol/L, respectively, P < 0.007) than in those aged >45 years (6.3 ± 1.8 and 3.1 ± 2.0 mmol/L, respectively, P < 0.001). Overall, 1745 and 879 patients were unvaccinated and fully vaccinated, respectively; severe and critical COVID-19 infections were more common among unvaccinated patients in both age groups. Conclusions: Younger patients with AMI were more likely to be smokers with no hypertension, diabetes mellitus, or previous AMI. In contrast, they were more likely to have hypercholesterolemia and hypertriglyceridemia, single-vessel disease, Type C lesions, and a history of drug-eluting stent use.