25岁以下年轻人初发急性心肌梗死的临床特点及长期预后分析.

Objective To investigate the clinical characteristics and long-term prognosis of patients aged under 25 years with acute myocardial infarction(AMI). Methods We enrolled the patients aged under 25 years(young group)who were diagnosed with AMI at The First Affiliated Hospital of Xi'an Jiaotong University from February 2013 to July 2023. And the patients who were admitted to the hospital during the same period and aged 25-44 years with the same gender and the same infarct sites were selected as the control group(young and middle-aged group)(1:2). The clinical data of the two groups including comorbidities, high risk factors and biochemical indicators were collected and compared, and prognostic factors were analyzed. Results In this study, we enrolled a total of 84 AMI patients: 28 in the young group and 56 in the young and middle-aged group. The patients in young group had single-vessel disease(15/26, 57.7%)and no obvious culprit vessel(7/26, 26.9%); their white blood cell count and uric acid level were significantly higher than those of the young and middle-aged group. The median follow-up was 72.4(25.5, 110.2)months in this study. The results of univariate and multivariate Cox proportional hazards regression model analysis showed that the younger group(HR=7.925, 95% CI: 1.861-33.749, P=0.005), length of hospital stay(HR=1.183, 95% CI: 1.001-1.398, P=0.048), and complicated typical angina symptoms(HR=0.090, 95%CI: 0.015-0.544, P=0.009)were independent factors affecting the patients' overall surivival. Conclusion Compared to middle-aged and young AMI patients, the younger AMI ones have a worse prognosis. Young patients(under 25 years), length of hospital stay and atypical angina symptoms are the most important risk factors for patients with AMI. Therefore, early detection and identification of AMI in young patients is helpful for improving the patients' prognosis. [ABSTRACT FROM AUTHOR]