Clinical outcomes and coronary artery lesion characteristics of young patients with ST elevation myocardial infarction and no standard modifiable risk factors

Lan NSR 1 , Chih H 2 , Brennan AL 3 , Dwivedi G 1 , Figtree GA 4 , Dinh D 3 Show all authors , Stub D 3 , Reid CM 2 , Ihdayhid AR 5 , ASPECT Investigators

Affiliations 

  • 1 Medical School, The University of Western Australia, Perth, Western Australia, Australia
  • 2 School of Population Health, Curtin University, Perth, Western Australia, Australia
  • 3 School of Public Health and Preventive Medicine, Monash University, Victoria, Melbourne, Australia
  • 4 Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
  • 5 Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
Catheter Cardiovasc Interv, 2024 Sep 09.
PMID: 39248198 DOI: 10.1002/ccd.31205

Abstract

BACKGROUND: Among ST-elevation myocardial infarction (STEMI) patients, those with no standard modifiable risk factors (SMuRFs: hypertension, diabetes mellitus, hypercholesterolemia, and smoking) have higher 30-day mortality than those with SMuRFs. Differences in coronary lesion characteristics remain unclear.

METHODS: Data from STEMI patients aged ≤60 years from the Asia Pacific Evaluation of Cardiovascular Therapies Network (Australia, Hong Kong, Malaysia, Singapore, and Vietnam) was retrospectively analysed. Exclusion criteria included incomplete SMuRF data, prior myocardial infarction, or prior coronary revascularisation. Lesion type was defined using the American College of Cardiology criteria. Major adverse cardiovascular events (MACE) were defined as peri-procedural myocardial infarction, emergency coronary artery bypass surgery, cerebrovascular event, or mortality. Multiple logistic regressions were used.

RESULTS: Of 4404 patients, 767 (17.4%) were SMuRFless. SMuRFless patients were more frequently younger (median age 51 vs. 53 years; p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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