Prevalence and temporal trends of risk factors among young patients with acute myocardial infarction - a nationwide cohort study

Abstract Background Cardiovascular disease, including acute myocardial infarction (AMI) is the leading cause of death globally.(1) While the risk of AMI is higher with increasing age, the consequences of AMI can be more severe in younger individuals, causing larger loss-of-life-expectancy and imposing burdens for society in terms of healthcare costs and premature retirements. Description of the young AMI cohort is of greatest interest to identify modifiable risk factors and/or other predisposing factors that may be optimized. Aims To describe the prevalence and temporal trend of risk factors among young individuals with AMI. Methods We used data from the SWEDEHEART registry, the National Patient Registry, the Drug Prescription registry and the Swedish Population registry. Adult young patients, defined as 18-59 years, admitted with a first AMI from January 2003 to January 2022 were included. Prevalence of the potentially modifiable risk factors; hypertension, diabetes, hyperlipidemia, smoking and obesity was defined on admission. In the analyses the cohort was further divided into two age groups 18-44 and 45-59 years. Results From January 2003 to January 2022, 249 735 patients were admitted with a first AMI and among these, 50 281 (20.1% of the total AMI cohort) were classified as young and included in the study. 44 243 (88.0%) patients were 45-59 years and 6038 (12%) were 18-44 years. The overall prevalence of risk factors was substantial, with higher rates observed in women compared to men (Table 1a) and in the older age group, except for obesity, which was more common in the younger age group (Table 1b). While the prevalence of diabetes and hyperlipdemia remained unchanged over time, smoking decreased and hypertension slightly increased. Notably, the prevalence of obesity more than doubled (Figure 1). Conclusion Among young AMI patients the prevalence of modifiable risk factors was substantial with an even higher prevalence in women than in men. The increasing prevalence of obesity especially in the younger age group may indicate a potential future rising health care risks.Figure 1