Characteristics and Clinical Outcomes of Young Patients with ST-segment Elevation Myocardial Infarction A Retrospective Study

Background ST-segment elevation myocardial infarction (STEMI) carries high mortality and poor outcomes without timely treatment. Its occurrence in young patients is especially concerning due to social impact. Objectives This study examined the characteristics and outcomes of young STEMI patients in Hong Kong to identify areas for public health improvement. Methods We retrospectively reviewed STEMI patients admitted to Princess Margaret Hospital from January 2019 to January 2023 who underwent coronary angiography and reperfusion therapy. Patients were grouped as young (years) or older (≥50 years). Results Out of 818 patients treated with PCI, 102 (12.5%) were under 50 years old. Compared to older patients, young STEMI patients were more often male, chronic smokers, South-Asian, and obese, with higher rates of untreated hypertension, diabetes mellitus, and hyperlipidemia. They exhibited less multivessel and significant left main coronary disease. Complications such as acute pulmonary edema, cardiogenic shock, and highgrade atrioventricular block were less frequent in the young group. Overall, young patients had more favorable outcomes, with lower mortality and 1-year major adverse cardiac events (MACE). However, the 1-year MACE rate of 18.6% in young patients was not negligible, and out-of-hospital cardiac arrest (OHCA) was significantly associated with 1-year MACE in this group but not in older patients Conclusion Young STEMI patients in Hong Kong have distinct risk factors and better outcomes than older patients, but their risk of adverse events is still notable. Enhanced public health efforts are needed to improve primary prevention in this group.