Risk profile and prognosis of myocardial infarction in young adults: a comparative study

Sofiene Haboubi; Meriem Ghozzia; Elyes Lagha; Mohamed Amine Soula; Rami Tlili; Meriam Drissa; Youssef Ben Ameur

doi:10.2478/rjc-2026-0017

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Risk profile and prognosis of myocardial infarction in young adults: a comparative study

Romanian Journal of Cardiology

AHEAD OF PRINT

By: Sofiene Haboubi, Meriem Ghozzia, Elyes Lagha, Mohamed Amine Soula, Rami Tlili, Meriam Drissa and Youssef Ben Ameur

Open Access

|Jul 2026

Figures & Tables

Study flowchart. A total of 303 patients were initially screened for eligibility. Of these, 97 were excluded based on the predefined exclusion criteria. The final study population comprised 206 patients, stratified according to age into two groups: 100 patients in the older STEMI group (G1, age >50 years) and 106 patients in the younger STEMI group (G2, age ≤50 years). STEMI, ST-segment elevation myocardial infarction.

Survival curves in young and old STEMI patients based on Kaplan-Meier estimates. Younger patients (G2) exhibited significantly higher survival rates compared with older patients (G1) (log-rank p < 0.05). HR, hazard ratio; STEMI, ST-segment elevation myocardial infarction.

Multivariable Cox survival regression plot. CS, reduced LVEF and age >50 years were independently associated with increased cardiovascular mortality. CI, confidence interval; CS: cardiogenic shock; HR, LVEF, left ventricular ejection fraction; MI: myocardial infarction.

Patients Outcomes_

	General population (n = 206)	G1 (n = 100)	G2 (n = 106)	p
Primary endpoint (%)	12 (5.8)	11 (11)	1 (0.9)	<0.01
Secondary endpoints (%)	53 (25.7)	26 (26)	27 (25.5)	0.96
Non-fatal MI (%)	42 (20.4)	18 (18)	24 (22.6)	0.4
AHF hospitalisation (%)	13 (6.3)	9 (9)	4 (3.8)	0.12
Stent thrombosis/restenosis (%)	29 (14.1)	12 (12)	17 (16.0)	0.41

Angiographic findings in the general population

	General population (n = 206)	G1 (n = 100)	G2 (n = 106)	p
Primary PCI (%)	129 (62.6)	61 (61)	68 (64.2)	0.78
Rescue PCI (%)	16 (7.8)	10 (10)	6 (5.7)	0.15
Radial access (%)	184 (89.3)	90 (90)	94 (88.7)	0.76
High thrombotic burden (%)	28 (13.6)	8 (8)	20 (18.9)	<0.05
Coronary status
Single-vessel (%)	92 (44.7)	31 (31)	61 (57.5)	<0.05
Multivessel (%)	105 (50.9)	66 (66)	39 (36.8)	<0.05
Syntax score	13.3 ± 11.9	16.7 ± 13.8	10.0 ± 8.9	<0.01
Culprit vessel
LAD (%)	96 (46.6)	44 (44)	52 (49.1)	0.45
RCA (%)	67 (32.5)	36 (36)	31 (29.2)	0.31
LMCA (%)	3 (1.5)	2 (2)	1 (0.9)	0.9
Cx (%)	19 (9.2)	13 (13)	6 (5.7)	0.08
Pre-revascularisation TIMI
0 (%)	71 (34.5)	33 (33)	38 (35.8)	0.14
II (%)	31 (15)	19 (19)	12 (11.3)	0.14
III (%)	95 (46.1)	41 (41)	54 (50.9)	0.14
Non-atheromatous causes
Coronary spasm (%)	5 (2.4)	2 (2)	3 (2.8)	0.7
SCAD (%)	5 (2.4)	1 (1)	4 (3.8)	0.2
Thromboembolic (%)	15 (7.3)	2 (2)	13 (12.3)	<0.05
Revascularisation modalities
DES (%)	86 (41.7)	42 (42)	44 (41.5)	0.89
BMS (%)	94 (45.6)	53 (53)	41 (38.7)	0.08
Glycoprotein IIb/IIIa inhibitors (%)	14 (6.8)	3 (3)	11 (10.4)	<0.05
Manual thrombectomy (%)	4 (1.9)	0 (0)	4 (3.8)	<0.05
No reflow (%)	7 (3.4)	4 (4)	3 (2.8)	0.63
Stentless strategy (%)	26 (12.6)	5 (5)	21 (19.8)	<0.05
Post-revascularisation TIMI
0 (%)	5 (2.4)	3 (3)	2 (1.9)	0.15
II (%)	5 (2.4)	0 (0)	5 (4.7)	0.15
III (%)	192 (93.2)	95 (95)	97 (91.5)	0.15

Population risk profile

	General population (n = 206)	G1 (n = 100)	G2 (n = 106)	p
Mean age (years)	52.8 ± 11.6	62.2 ± 7.9	43.3 ± 5.2	p < 0.05
Female gender (%)	36 (17.5)	25 (25)	11 (10.4)	p < 0.05
Family history CAD (%)	31 (15)	7 (7)	24 (22.6)	p < 0.05
HTN (%)	64 (31.1)	39 (39)	25 (23.6)	p < 0.05
DM (%)	101 (49)	58 (58)	43 (40.6)	p < 0.05
CVA (%)	7 (3.4)	7 (7)	0 (0)	p < 0.05
Dyslipidaemia (%)	32 (15.5)	16 (16)	16 (15.1)	p = 0.86
Obesity (%)	17 (8.3)	6 (6)	11 (10.4)	p = 0.25
Former smoker (%)	11 (5.3)	5 (5)	6 (5.7)	p = 0.83
Current smoker (%)	150 (72.8)	60 (60)	90 (84.9)	p < 0.0001
CHAU (%)	39 (18.9)	7 (7)	32 (30.2)	p < 0.0001
Cannabis use (%)	14 (6.8)	2 (2)	12 (11.3)	p < 0.05
Cocaine use (%)	1 (0.5)	0 (0)	1 (0.9)	p = 0.33
CKD (%)	4 (1.9)	1 (1)	3 (2.8)	p = 0.34
AAD (%)	2 (1)	0 (0)	2 (1.9)	p = 0.17
AF (%)	5 (2.4)	5 (5)	0 (0)	p < 0.05

Clinical presentation in general population_

	General population (n = 206)	G1 (n = 100)	G2 (n = 106)	p
Anterior MI (%)	90 (43.7)	43 (43)	47 (44.3)	0.57
Inferior MI (%)	81 (39.3)	42 (42)	39 (36.8)	0.08
LBBB (%)	3 (1.5)	3 (3)	0 (0)	0.07
Time from pain to first contact (hr)	10.7 ± 13.6	12.72 ± 14.62	8.8 ± 12.3	<0.05
Subacute STEMI presentation (%)	52 (25.2)	31 (31)	21 (19.8)	0.06
HR (bpm)	81.3 ± 16	81 ± 16.1	81.7 ± 16.0	0.75
CS (%)	18 (8.7)	11 (11)	7 (6.6)	0.26
AHF (%)	43 (20.9)	20 (20)	23 (21.7)	0.76
VT/VF (%)	9 (4.4)	3 (3)	6 (5.7)	0.35
AVB (%)	11 (5.3)	8 (8)	3 (2.8)	0.09
Resuscitated CA (%)	5 (2.4)	2 (2)	3 (2.8)	0.7
LVEF (%)	47.6 ± 12	47.2 ± 12.3	47.9 ± 11.7	0.67
Reduced LVEF ≤ 40% (%)	67 (32.5)	34 (34)	33 (31.1)	0.89
LDL-C (g/L)	1.2 ± 0.4	1.2 ± 0.5	1.2 ± 0.4	0.81
HbA1c (%)	7 ± 2.2	8.0 ± 2.7	6.4 ± 1.8	<0.05
Creatinine (μmol/L)	85.5 ± 49.4	89.7 ± 57.5	81.5 ± 40	0.24
Troponins (ng/L)	18 640 ± 14 989.6	19115 ± 16099.6	18232 ± 14043.2	0.7
Hyperhomocysteinemia (%)	2 (1)	0 (0)	2 (1.9)	0.05
Thrombophilia (%)	2 (1)	0 (0)	2 (1.9)	0.05
APS (%)	1 (0.5)	0 (0)	1 (0.9)	0.24

Patients follow-up parameters

	General population (n = 198)	G1 (n = 93)	G2 (n = 105)	p
Angina
CCS 2 (%)	23 (11.6)	9 (9.7)	14 (13.3)	0.8
CCS 3 (%)	4 (2.0)	2 (2.2)	2 (1.9)	0.8
Dyspnoea
NYHA II (%)	22 (11.1)	10 (10.8)	12 (11.4)	0.29
NYHA III (%)	5 (2.5)	4 (4.3)	1 (1)	0.29
Smoking cessation (%)	60 (30.3)	15 (16.1)	45 (42.9)	<0.05
Therapeutic adherence (%)	154 (77.8)	70 (75.3)	84 (80)	0.98
HR (bpm)	68.9 ± 13.9	69 ± 12.9	68.8 ± 14.7	0.9
SBP (mmHg)	124.1 ± 21.8	124.8 ± 27.2	123.4 ± 15.8	0.65
LDL-C (g/L)	0.9 ± 0.3	0.8 ± 0.3	0.9 ± 0.3	0.2
LVEF (%)	48.7 ± 11.3	49 ± 12	48.5 ± 10.7	0.78
Mean follow-up duration (months)	38.7 ± 19.3	42.4 ± 21.9	35.2 ± 15.8	p < 0.05

Pharmacological treatment

	General population (n = 206)	G1 (n = 100)	G2 (n = 106)	p
Ticagrelor (%)	20 (9.7)	6 (6)	14 (13.2)	0.08
Clopidogrel (%)	182 (88.3)	93 (93)	89 (84)	0.2
Aspirin (%)	199 (96.6)	97(97)	102 (96.2)	0.45
B-blockers (%)	188 (91.3)	85 (85)	103 (97.1)	<0.05
ACEi (%)	163 (79)	79 (79)	84 (79.3)	0.32
ARNi (%)	1 (0.5)	0 (0)	1 (0.9)	0.33
MRA (%)	30 (14.6)	17 (17)	13 (12.3)	0.32
Statins (%)	196 (95.1)	97 (97)	99 (93.4)	0.1
SGLT2i (%)	39 (19)	12 (12)	27 (25.5)	<0.05
DOAC (%)	3 (1.5)	0 (0)	3 (2.8)	0.09
Acenocoumarol (%)	11 (5.3)	5 (5)	6 (5.7)	0.85

Logistic regression analysis of factors associated with STEMI in young patients

Predictor	OR	p	95% CI
Family history of CAD	2.85	0.034	1.08–7.50
Female gender	0.95	0.9	0.38–2.38
HTN	0.77	0.45	0.39–1.52
DM	0.69	0.24	0.37–1.29
Current smoking	2.58	0.016	1.19–5.60
CHAU	4.13	0.003	1.63–10.5

Early adverse events

	General population (n = 206)	G1 (n = 100)	G2 (n = 106)	p
Early CV mortality (%)	8 (3.9)	7 (7)	1 (0.9)	<0.05
Subacute stent thrombosis (%)	2 (1)	1 (1)	1 (0.9)	0.96
CIN (%)	4 (1.9)	3 (3)	1 (0.9)	0.28
Mechanical complications (%)	2 (1)	1 (1)	1 (0.9)	0.97
AF (%)	9 (4.4)	5 (5)	4 (3.8)	0.68
AHF hospitalisation (%)	13 (6.3)	9 (9)	4 (3.8)	0.46
Stroke (%)	3 (1.5)	3 (3)	0 (0)	0.07

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DOI: https://doi.org/10.2478/rjc-2026-0017 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X

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Language: English

Published on: Jul 8, 2026

Published by: Romanian Society of Cardiology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

myocardial infarction,

coronary artery disease,

Related subjects:

Surgery,

Pediatrics and juvenile medicine,

Paediatric cardiology

© 2026 Sofiene Haboubi, Meriem Ghozzia, Elyes Lagha, Mohamed Amine Soula, Rami Tlili, Meriam Drissa, Youssef Ben Ameur, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

AHEAD OF PRINT

Risk profile and prognosis of myocardial infarction in young adults: a comparative study

Figures & Tables

Figure 1

Figure 2

Figure 3

Patients Outcomes_

Angiographic findings in the general population

Population risk profile

Clinical presentation in general population_

Patients follow-up parameters

Pharmacological treatment

Logistic regression analysis of factors associated with STEMI in young patients

Early adverse events

Paradigm

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