Perfil clínico y pronóstico de pacientes jóvenes con infarto agudo de miocardio con elevación del segmento ST tratados en la red Codi IAM / Clinical profile and prognosis of young patients with ST-elevation myocardial infarction managed by the emergency-intervention Codi IAM network

Introducción y objetivos: Los datos sobre el perfil clínico y los resultados de los pacientes jóvenes con infarto agudo de miocardio con elevación del segmento ST (SCACEST) son escasos. Este estudio compara las características y los resultados clínicos entre pacientes de edades<45 años y ≥ 45 con IAMCEST atendidos por el sistema catalán Codi IAM. También se analizaron las diferencias por sexo en el grupo de menores de 45 años.Métodos: Entre 2015 y 2020, se incluyó a todos los pacientes ingresados por IAMCEST. Los objetivos primarios fueron la mortalidad por cualquier causa en los primeros 30 días, a 1 año y 2 años.Resultados: Se incluyó a 18.933 pacientes (el 23% mujeres). De ellos, 1.403 (7,4%) eran menores de 45 años. Los pacientes más jóvenes eran más fumadores (p<0,001) y presentaron tasas más altas de muerte súbita y flujo TIMI 0 antes de la ICPp (p<0,05), pero el tiempo desde el primer contacto médico hasta el paso de la guía fue más corto en comparación con el grupo de más edad (p<0,05). Se observaron tasas de mortalidad por cualquier causa más bajas en los pacientes menores de 45 (p<0,001). Con respecto a las diferencias estratificadas por sexo en los pacientes más jóvenes, el shock cardiogénico fue más frecuente en las mujeres que en los varones (p=0,002) y el tiempo desde el inicio de los síntomas hasta la reperfusión fue más largo (p<0,05) en el grupo de las mujeres. En comparación con los varones de menos de 45, las mujeres más jóvenes tenían menos probabilidades de tratarse con ICPp (p=0,004).Conclusiones: Pese a presentar características de alto riesgo al ingreso, los pacientes jóvenes que sufren un IAMCEST tienen mejor pronóstico que sus contrapartes mayores. Se observaron diferencias en los tiempos de isquemia y tratamiento entre varones y mujeres.(AU)

Introduction and objectives: Data on the clinical profile and outcomes of younger patients with ST-elevation myocardial infarction (STEMI) is scarce. This study compared clinical characteristics and outcomes between patients aged<45 years and those aged ≥ 45 years with STEMI managed by the acute myocardial infarction code (AMI Code) network. Sex-based differences in the younger cohort were also analyzed.Methods: This multicenter study collected individual data from the Catalonian AMI Code network. Between 2015 and 2020, we enrolled patients with an admission diagnosis of STEMI. Primary endpoints were all-cause mortality within 30 days, 1 year, and 2 years.Results: Overall, 18 933 patients (23% female) were enrolled. Of them, 1403 participants (7.4%) were aged<45 years. Younger patients with STEMI were more frequently smokers (P<.001) and presented with cardiac arrest and TIMI flow 0 before pPCI (P<.05), but the time from first medical contact to wire crossing was shorter than in the older group (P<.05). All-cause mortality rates were lower in patients aged<45 years (P<.001). Among younger patients, cardiogenic shock was most prevalent in women than in their male counterparts (P=.002), with the time from symptom onset to reperfusion being longer (P<.05). Compared with men aged<45 years, younger women were less likely to undergo pPCI (P=.004).Conclusions: Despite showing high-risk features on admission, young patients exhibit better outcomes than older patients. Differences in ischemia times and treatment were observed between men and women.(AU)

Clinical profile and prognosis of young patients with ST-elevation myocardial infarction managed by the emergency-intervention Codi IAM network.

INTRODUCTION AND OBJECTIVES: Data on the clinical profile and outcomes of younger patients with ST-elevation myocardial infarction (STEMI) is scarce. This study compared clinical characteristics and outcomes between patients aged<45 years and those aged ≥ 45 years with STEMI managed by the acute myocardial infarction code (AMI Code) network. Sex-based differences in the younger cohort were also analyzed. METHODS: This multicenter study collected individual data from the Catalonian AMI Code network. Between 2015 and 2020, we enrolled patients with an admission diagnosis of STEMI. Primary endpoints were all-cause mortality within 30 days, 1 year, and 2 years. RESULTS: Overall, 18 933 patients (23% female) were enrolled. Of them, 1403 participants (7.4%) were aged<45 years. Younger patients with STEMI were more frequently smokers (P<.001) and presented with cardiac arrest and TIMI flow 0 before pPCI (P<.05), but the time from first medical contact to wire crossing was shorter than in the older group (P<.05). All-cause mortality rates were lower in patients aged<45 years (P<.001). Among younger patients, cardiogenic shock was most prevalent in women than in their male counterparts (P=.002), with the time from symptom onset to reperfusion being longer (P<.05). Compared with men aged<45 years, younger women were less likely to undergo pPCI (P=.004). CONCLUSIONS: Despite showing high-risk features on admission, young patients exhibit better outcomes than older patients. Differences in ischemia times and treatment were observed between men and women.