Acute myocardial infarction in patients under forty-five years of age: What has changed in ten years?

Introduction/Aim. The incidence of acute myocardial infarction (AMI) is declining in developed countries due to better prevention and more effective treatment of risk factors, however, the proportion of younger patients with AMI is increasing. The aim of the research was to compare patients under the age of 45 years with acute myocardial infarction at a ten-year interval, to detect changes in frequency and risk factors of AMI. Material and methods. The retrospective study included patients under the age of 45 years, hospitalized at the Cardiology Clinic, University Clinical Center Niš, with a diagnosis of AMI during 2023 and 2013. The frequency of AMI, risk factors for coronary artery disease, the way of presentation and prevalence of coronary artery disease in both groups were compared. Results. During the ten-year period, the total number of patients annually hospitalized with AMI increased (985 vs 1691). The proportion of younger patients increased significantly from 18 (1.7%) in 2013 to 57 (3.4%) in 2023, p = 0.008. The youngest patient with AMI in 2013 was 31 years old and in 2023, 25 years. The groups differed significantly in average age (43.3 years in 2013 vs 33.2 years in 2023, p = 0.02). Significantly more patients had dyslipidemia (89.8% vs 47.1%) and positive family history (87.8% vs 47.1%) in the 2023 group. The majority of patients in both groups presented with ST-segment elevation myocardial infarction (STEMI) and the majority had single-vessel disease. During 2023, the number of younger patients with three-vessel disease increased (5.3% vs 0%). Conclusion. The proportion of patients aged up to 45 years among patients with AMI in our community has increased over the last ten years, and the average age and the minimum age of this patient group have decreased, with a higher frequency of dyslipidemia, heredity, and three-vessel coronary disease.