Treatment and outcomes of patients under 40 years of age with acute myocardial infarction in Poland in 2009–2013: an analysis from the PL‑ACS registry

INTRODUCTION    Patients under the age of 40 years represent from 1% to 6% of all patients with acute myocardial infarction (AMI).
OBJECTIVES    We aimed to analyze the recent trends in the clinical presentation, treatment, and both
the in‑hospital and 12‑month outcomes of patients under 40 years of age with ST‑segment elevation myocardial infarction (STEMI) and non‑STEMI (NSTEMI), treated from 2009 to 2013.
PATIENTS AND METHODS    The study included 1639 young patients with AMI under the age of 40 years included in the PL‑ACS registry (1.3% of all patients with AMI). Trends in the period from 2009 to 2010 (643 patients) and from 2012 to 2013 (676 patients) were analyzed.
RESULTS    The percentage of admissions for STEMI decreased (71.7% vs 63.9%; P = 0.002), while that of admissions for NSTEMI increased (28.3% vs 36.1%; P = 0.002) over the years. There was no difference in the in‑hospital mortality (1.7% vs 1.6%; P = 1.0). The percentage of patients treated invasively increased from 90.7% in the period 2009–2010 to 95.7% in the period 2012–2013 (P = 0.0003). There was no difference between the groups in the incidence of death (2.5% vs 2.8%; P = 0.72) or the rate of the composite endpoint of death, recurrent AMI, or stroke within 1 year of the index hospitalization (5.3% vs 5.6%, P = 0.80).
CONCLUSIONS    There was no significant difference in the in‑hospital and 12‑month outcomes between the patients under 40 years of age with STEMI and NSTEMI hospitalized in the years 2009–2010 and those treated in the years 2012–2013. The relative percentage of patients with NSTEMI and those treated invasively increased significantly over the years.