Ashwal, AJ (2019) The young myocardial infarction study of the Western Indians. Global Heart, 14 (1). pp. 27-33. ISSN 2211-8160

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Abstract

Background: Myocardial infarction is among the leading causes of morbidity and mortality in young adults around the world. Objectives: In the YOUTH (Young Myocardial Infarction Study of the Western Indians) registry, we aimed to evaluate risk factor profile and angiographic outcomes of reperfusion therapies of infarct-related artery in young western Indians (�40 years) having ST-segment elevation myocardial infarction. Methods: A total of 1,179 consecutive patients aged �40 years who presented with ischemic heart disease from June 2012 to December 2014 were enrolled in the YOUTH registry. A total of 787 patients with ST-segment elevation myocardial infarction were further evaluated. Categorical data was assessed using chi-square test, whereas continuous data was assessed using Student’s t test. Regression analysis was performed to investigate the strength of association. Results: In the YOUTH registry, the study population was predominantly male (93%) with tobacco consumption as major prevalent risk factor (49.7%). Of 787 patients, 451 (57.31%) were thrombolyzed, 326 (41.42%) did not receive any reperfusion therapy, and 10 patients (1.27%) underwent primary angioplasty. Younger age, window period <6 h, and lower lipoprotein (a) level were observed in patients with a recanalized infarct-related artery. Regression analysis showed window period of thrombolysis as strongest predictor (odds ratio: 1.790, 95% confidence interval: 1.144e2.802; p < 0.011) of successful reperfusion. Patients (n ¼ 235) being thrombolyzed in a window period of <6 h, had higher rate of infarctrelated artery recanalization (77%) as compared to those with �6 h window period (23%). In hospital mortality was 0.38% (n ¼ 3), whereas bleeding complication was noted only in 1 patient. Conclusions: We herewith conclude that acute short-term outcome is favorable in young ST-segment elevation myocardial infarction patients, particularly in those who had received timely thrombolytic therapy. Though tobacco consumption was a major contributor of risk in young adults, prevalence of other risk factors was low in young Western Indians.

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