Perceived stress in young patients with myocardial infarction: A case–control study from a tertiary care center in India

Background: Cardiovascular disease is increasingly affecting younger individuals in India. Psychosocial stress has emerged as an important modifiable risk factor, but data among young myocardial infarction (MI) patients remain limited. Aims and Objectives: To evaluate perceived stress levels in young patients with MI and examine their association with demographic, socioeconomic, and clinical variables. Materials and Methods: This hospital-based cross-sectional case–control study included 100 young MI patients (18–45 years) and 100 age- and gender-matched controls. Perceived stress was assessed using the perceived stress scale, and socioeconomic status was evaluated using the Modified Kuppuswamy Scale (2022). Statistical analysis was performed using the statistical package for the Social Sciences. A P<0.05 was considered statistically significant. Results: Demographic and anthropometric parameters were comparable between groups. Conventional risk factors were significantly more prevalent among cases, including hypertension (31% vs. 10%), diabetes mellitus (11% vs. 2%), obesity (10% vs. 2%), smoking (62% vs. 23%), alcohol consumption (51% vs. 26%), and family history of coronary artery disease (16% vs. 6%) (all P<0.05). Lower socioeconomic status was more common among cases (76% vs. 63%, P=0.046). Moderate-to-high perceived stress was observed in 90% of cases compared with 76% of controls (P=0.008). Hypertension (adjusted odds ratio [OR] 4.74; 95% confidence interval [CI]: 1.93–11.65; P=0.001), smoking (adjusted OR 4.19; 95% CI: 1.96–8.98; P<0.001), and moderate-to-high perceived stress (adjusted OR 3.45; 95% CI: 1.36–8.76; P=0.009) were independent predictors of MI on multivariate logistic regression analysis. Conclusion: Young patients with MI exhibit significantly higher perceived stress and a greater burden of traditional cardiovascular risk factors compared with controls. After multivariate adjustment, moderate-to-high perceived stress remained independently associated with premature MI. Incorporation of stress assessment into cardiovascular risk evaluation may be beneficial; however, prospective studies are required to establish causality.