Korean Circ J.  2015 Jul;45(4):275-284. 10.4070/kcj.2015.45.4.275.

Clinical Characteristics and Outcomes of Acute ST-Segment Elevation Myocardial Infarction in Younger Korean Adults

• Lee SH
• Kim JH
• Jeong MH
• Park H
• Jeong YA
• Ahn Y
• Kim JH
• Chae SC
• Kim YJ
• Hur SH
• Seong IW
• Hong TJ
• Choi D
• Cho MC
• Kim CJ
• Seung KB
• Chung WS
• Jang YS
• Cho JG
• Park JC
• Park SJ
• Other Korea Acute Myocardial Infarction Registry Investigators

• KMID: 1964099
• DOI: http://doi.org/10.4070/kcj.2015.45.4.275

Abstract

BACKGROUND AND OBJECTIVES
This study aims to investigate the clinical features, angiographic findings, and outcomes of younger Korean ST-segment elevation myocardial infarction (STEMI) patients.
SUBJECTS AND METHODS
We analyzed major adverse cardiac events (MACE) in the Korea Acute Myocardial Infarction Registry from November 2005 to October 2010. The registered patients were divided into two groups; young age group (<65 years) and old age group (> or =65 years).
RESULTS
The young age group included 5281 patients (age, 53+/-7.8 years), and the old age group included 4896 patients (age, 74.3+/-6.5 years). Male gender, smoking, family history, dyslipidemia, and metabolic syndrome were more frequently observed in the young age group than in the old age group (89.5% vs. 59.3%, p<0.001; 77.3% vs. 47.2%, p<0.001; 11% vs. 4.6%, p<0.001; 11.2% vs. 7.7%, p<0.001; 67.6% vs. 62.9%, p<0.001). Most of the young Korean adults with STEMI complained of typical chest pain (89.8%), and they had a shorter symptom-to-door time (12+/-53.2 hours vs. 17.3+/-132 hours, p=0.010). The young age group showed a favorable prognosis, which was represented by the MACE, compared with the old age group at one month (1.8% vs. 2.8%, p=0.028), six months (6.8% vs. 8.2%, p<0.001), and twelve months (10.1% vs. 11.9%, p=0.025). However, there was no significant difference in the adjusted MACE rate at one month {hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.60-1.51, p=0.828} and twelve months (HR 0.86, 95% CI 0.68-1.10, p=0.233).
CONCLUSION
Younger Korean adults with STEMI have clinical outcomes similar to old aged patients, and therefore, they should be treated intensively like the elderly patients.

Keyword

Myocardial infarction; Young adult; Prognosis

MeSH Terms

Adult*
Aged
Chest Pain
Dyslipidemias
Humans
Korea
Male
Myocardial Infarction*
Prognosis
Smoke
Smoking
Young Adult
Smoke

Figure

• 

  Fig. 1 Adjusted MACE-free survival (A) and death-free survival at 12 months by multivariate Cox regression analyses (B). MACE: major adverse cardiac event, HR: hazard ratio.

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