Acute myocardial infarction in the young— The University of Michigan experience

• Published in: The American heart journal Vol. 143; no. 1; pp. 56 - 62
• Main Authors: Doughty, Michele, Mehta, Raj, Bruckman, David, Das, Sugata, Karavite, Dean, Tsai, Thomas, Eagle, Kim
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.01.2002; Elsevier Limited
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Analysis of Variance; Angioplasty; Anticoagulants - therapeutic use; Aspirin - therapeutic use; Cardiology; Coronary Artery Bypass; Coronary vessels; Diabetes Complications; Diabetes Mellitus - epidemiology; Female; Heart attacks; Heart Failure - complications; Heart Failure - epidemiology; Heparin - therapeutic use; Humans; Hyperlipidemias - complications; Hyperlipidemias - epidemiology; Hypertension - complications; Hypertension - epidemiology; Male; Michigan - epidemiology; Middle Aged; Mortality; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Myocardial Infarction - etiology; Myocardial Infarction - therapy; Prospective Studies; Risk Factors; Smoking - adverse effects; Smoking - epidemiology; Michigan
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1067/mhj.2002.120300

Background The purpose of this study was to assess frequency, risk factors, treatment, and complications of very young patients with acute myocardial infarction (MI) at the University of Michigan Medical Center (UMMC). Methods From a database of 976 consecutive patients admitted to the UMMC with acute MI between 1995 and 1998, we compared care and outcomes of patients divided into 3 age categories: <46 years, 46-54 years, and >54 years. Risk factors, presenting symptoms, type of MI, management, complications, and hospital outcomes of the 3 groups were evaluated. Results Young patients represented >10% of all patients with acute MI, and >25% of these individuals were women, a number considerably higher than seen in previous studies. This group of young patients was more likely to have Q-wave MI and risk factors such as family history and tobacco use and less likely to have a history of angina. Although all 3 groups received similar inpatient treatment, there was more attention paid to risk factor modification such as smoking cessation and referral to cardiac rehabilitation in younger individuals. Young patients had fewer in-hospital complications and a lower mortality rate. Conclusions At the University of Michigan, >1 in 10 with acute MI is <46 years old. Data suggest that current management and aggressive risk factor modification are quite good in this particular group, and overall the mortality rate is very low. (Am Heart J 2002;143:56-62.)