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

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.