Trends of myocardial infarction in young patients.

AIM: While the overall incidence and mortality of ST-elevation myocardial infarction (STEMI) have declined, younger adults 18-40 years of age have experienced a different trend. We examined STEMI incidence, mortality, and mechanical circulatory support (MCS) utilization in young patients from 2004 to 2023 using the TriNetX Research Network database.

METHODS

We conducted an analysis of a cohort of 34,888, 311 patients aged 18-40 years between January 1, 2004, and December 31, 2023, using TriNetX Research Network database. Linear regression analysis was used to calculate the incidence rate of STEMI. The incidence of major cardiovascular risk factors including diabetes mellitus, hypertension, nicotine dependence, obesity, cocaine use disorder, and stimulant use disorder, were evaluated in the same cohort over the same period. Mortality and MCS utilization were examined from 2010 onward.

RESULTS

STEMI incidence rate increased significantly from 2004 to 2023 (1.59/100,000 cases/person-year; p < 0.0001). Mortality incidence rate increased annually by 108/100,000 (p < 0.0001), while MCS utilization rose by 38.8/100,000 (p < 0.0001). Cardiovascular risk factors also increased significantly.

CONCLUSION

STEMI incidence, mortality, and MCS utilization among young adults have increased between 2004 and 2023, with a steeper uptrend observed post-COVID. Further research is needed to identify effective prevention and treatment strategies for STEMI in young adults, particularly in the post-COVID era.