The prevalence of young ST-elevation myocardial infarction, the risk factors, and the pattern of coronary artery involvement in the Serdang PPCI Registry over 7 years

Abstract

Abstract Background Acute coronary syndrome has remained Malaysia's leading cause of death for the past 15 years, with a more than 50% increase in the last ten years. There is limited published literature focusing on this population. Hence, we aim to assess the clinical risk factors, angiographic profile, and outcome of young patients (aged ≤ 40 years) with acute STEMI from the Serdang Primary PCI STEMI Network over a period of 7 years. Methods We evaluated all patients ≤40 years of age admitted with acute ST-segment elevation acute myocardial infarction (STEMI) who were studied between May 2015 and December 2022 at Serdang Heart Center Hospital. Risk factors were determined by review of electronic medical records. The primary outcomes of interest were all-cause mortality. Results Out of 1374 patients, 184 were very young STEMI patients, accounting for 13.4% of all patients in our study, with the majority being male (92.9%). The average age was 34.61±4.71. The mean pain score was 5.7±2.4. Anterior wall MI was present in 90 patients (48.9%), inferior wall MI in 84 patients (45.7%), lateral wall MI in 9 patients (4.9%), and left main stem MI in 1 patient (0.5%). The prevalence of diabetes mellitus was 27.7%, with a mean HbA1c of 6.9±2.4. With a mean TC of 5.68±1.61 mmol/L and a mean LDL of 3.70±1.48 mmol/L, the prevalence of dyslipidaemia was 49.5%. The mean creatinine was 83.04±21.04. The majority presented a Killip I score, which accounted for 91.3%. The radial vascular access was 84.8%. Single-vessel disease was the most common finding, at 77.7%. At 1 month, 98.4% of patients survived. Conclusion STEMI in people under the age of 40 is almost entirely seen in men. Around 15% of patients have no significant stenosis of the coronary arteries. Anterior-wall MI is more common, and more than three-quarters of patients have single-vessel disease. The 1-month survival rate is high.