Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jun 26, 2025; 17(6): 106445
Published online Jun 26, 2025. doi: 10.4330/wjc.v17.i6.106445
Acute myocardial infarction in the young: A 3-year retrospective study
Ahmed Hegazi Abdelsamie, Hani Omar Abdelhadi, Ahmed Taha Abdelwahed
Ahmed Hegazi Abdelsamie, Hani Omar Abdelhadi, Ahmed Taha Abdelwahed, Department of Cardiology, Mouwasat Hospital Dammam, Dammam 32263, Saudi Arabia
Author contributions: Hegazi Abdelsamie A was responsible for data collection, analysis and interpretation, drafting of manuscript, data preparation and presentation; Hegazi Abdelsamie A and Abdelhadi HO were responsible for study design and conception; Hegazi Abdelsamie A and Abdelwahed AT were responsible for literature review; Abdelhadi HO was responsible for supervision of the research; Abdelwahed AT was responsible for revising and editing the manuscript critically for important intellectual contents; Hegazi Abdelsamie A, Abdelhadi HO, and Abdelwahed AT were responsible for research coordination and management; all of the authors read and approved the final version of the manuscript to be published.
Institutional review board statement: The study protocol was approved by Institutional Review Board of Mouwasat Hospitals (No. 2023-D-002).
Informed consent statement: Informed consent was obtained from all participants included in this study.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: All data generated or analyzed during this study are included in this published article and its supplementary information files. The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Hegazi Abdelsamie, Research Fellow, Department of Cardiology, Mouwasat Hospital Dammam, Emam Termisi Street, Dammam 32263, Saudi Arabia. doc.hegazi@hotmail.com
Received: February 26, 2025
Revised: April 24, 2025
Accepted: May 24, 2025
Published online: June 26, 2025
Processing time: 113 Days and 23.6 Hours
Abstract
BACKGROUND

Acute myocardial infarction (AMI) is rare among patients aged ≤ 40 years but imposes significant morbidity, psychological distress, and economic burden. Approximately 10% of AMI hospitalizations involve patients under 45 years, underscoring the need to study this group. Compared to older patients, young AMI patients exhibit fewer traditional risk factors (e.g., hypertension, diabetes) but higher rates of smoking, obesity, and non-atherosclerotic causes like spontaneous coronary artery dissection or coronary spasm, often linked to substance use. Global trends show rising obesity and dyslipidemia in young populations, with smoking contributing to 62%–90% of AMI cases in this age group. Family history of coronary artery disease also elevates risk, particularly in acute coronary syndrome. Studies like Bhardwaj et al report that young AMI patients are predominantly male with single-vessel disease, unlike the multi-vessel disease typical in older cohorts. This study characterizes AMI in young adults (≤ 40 years) at a single center, focusing on presentation, risk factors, angiographic findings, and management to guide preventive strategies.

AIM

To describe the characteristics of AMI in young patients, including presentation, risk factors, coronary angiography (CAG) findings, and management strategies.

METHODS

This retrospective cross-sectional study analyzed 91 patients aged 20–40 years diagnosed with AMI at Mouwasat Hospital Dammam, from June 2020 to May 2023. Data on clinical presentation, cardiovascular risk factors, CAG findings, and treatments were collected from medical records. Descriptive statistics were used to summarize findings.

RESULTS

Of 91 patients (96.7% male, mean age 35.9 years ± 3.4 years), 43.9% were obese (body mass index > 30 kg/m²). Hyperlipidemia was the most prevalent risk factor (69.2%), followed by smoking (49.5%), diabetes mellitus (33.0%), and hypertension (26.4%). ST-elevation myocardial infarction (STEMI) was the most common presentation (57.1%). The left anterior descending artery was frequently affected (78.0%), with single-vessel disease predominant (72.5%). Most patients underwent percutaneous coronary intervention (PCI) (74.7%), while 8.8% required surgery.

CONCLUSION

Young AMI patients are predominantly obese males with hyperlipidemia and smoking as key risk factors, presenting with STEMI and single-vessel disease amenable to PCI.

Keywords: Acute myocardial infarction; Cardiovascular risk factors; Young adults; Coronary angiography; Coronary artery disease

Core Tip: This retrospective single-center study aimed to describe characteristics of acute myocardial infarction (AMI) in young patients, including presentation, risk factors, coronary angiography findings, and management strategies for AMI in a young population aged less than 40 years. The most common presenting diagnosis was ST-elevation myocardial infarction, with the left anterior descending artery being the most frequently affected artery. Most patients required percutaneous coronary intervention with single stent placement. Obesity and hyperlipidemia were identified as major risk factors for developing AMI in young individuals. Early screening for traditional risk factors and appropriate treatment in the young population is crucial for the primary prevention of AMI.