ST Elevation myocardial infarction in young adults: Prevalence, demographics, risk factor profile and early outcome after primary percutaneous coronary intervention

ObjectivesWe sought to investigate prevalence, clinical profile,in-hospital and long term clinical outcomes of Primary Percutaneous Coronary Intervention in young adults presenting with Acute MI.MethodsTotal of 95 patients ⩽40 years were enrolled in retrospective data analysis.Prevalence,risk factor profile and demographics were analyzed. Procedural success,in-hospital and short-term (1 month) outcomes were assessed as primary end points.Secondary end-points were recurrent MI and new revascularization.ResultsMean age was 36±14 years (range 19–40); 97% males and 3% females. 59(62%) patients presented with anterior wall MI, 36(38%) with inferolateral wall MI; 5% had infarction in other territories. 51% patients were Saudis and 49% were non Saudis.Risk factor profile revealed-Smoking (76%), Diabetes Mellitus (22%), Hypertension (20%), Dyslipidemia (12%), Family History (12%). 3 patients had cardiogenic shock at presentation. All underwent PPCI, with door to balloon time of 83±05min (74–220min). Majority had SVD (47%). 2VD and 3VD was seen in 33% and 18% respectively. (Infarct related artery: LAD 54%, RCA 23%, LCX 12% and Left Main Disease 2%). DES was deployed in 89%. Successful recanalisation of IRA was achieved in 95% with 87% achieving TIMI III flow. No reflow occurred in 2%. Procedure related coronary artery dissection occurred in 1 patient. 6% developed Ventricular Tachycardia, 2 patients developed complete heart block. In-hospital mortality was 3%. 1 patient had acute stent thrombosis and 4 patients presented with subacute and late stent thrombosis on follow up. All patients were alive at one-month follow up.ConclusionsOur data reveal that younger patients, predominantly males comprise a significant proportion of patients of STEMI. Smoking appears to be a prominent risk factor. Such patients have a favorable outcome after Primary PCI. High incidence of stent thrombosis in our cohort of patients needs further assessment