Clinico-Biochemical Profile and Outcomes in Young Adults With ST-Segment Elevation Myocardial Infarction at a Tertiary Care Hospital: An Observational Study

Background ST-elevation myocardial infarction (STEMI) in young adults is increasingly recognized, with distinct risk factor profiles and potential differences in clinical outcomes compared to older patients. However, data from the Indian context remain limited, particularly regarding thrombolysis response. Objectives The aim of this study was to compare the clinical profile, risk factors, laboratory parameters, and outcomes of STEMI between young adults (≤45 years) and older patients (>45 years), with a focus on thrombolysis outcomes. Methods This prospective observational study included 60 patients with STEMI admitted to a tertiary care center over six months. Patients were categorized into young (≤45 years, n=16) and older (>45 years, n=44) groups. Clinical presentation, risk factors, laboratory parameters, electrocardiographic findings, thrombolysis characteristics, and outcomes were compared. Statistical analysis was performed using the chi-square test for categorical variables, with p<0.05 considered significant. Results Young adults constituted 16 (26.7%) cases and were predominantly male (45, 75.0%). Smoking was significantly more prevalent among younger patients (seven, 43.8% vs seven, 15.9%, p=0.024), while diabetes mellitus was more common in older patients (24, 54.5% vs four, 25.0%, p=0.042). Clinical presentation and ECG patterns were comparable between the groups. Younger patients had significantly higher white blood cell counts (11993.75 ± 3630.70 vs 9479.55 ± 2791.23 /µL, p=0.006) and platelet counts (312250 ± 75964.47 vs 261045.45 ± 60385.18 /µL, p=0.009). Despite similar door-to-needle times, successful thrombolysis was significantly lower among younger patients (seven, 43.8% vs 33, 75.0%, p=0.023). Overall clinical outcomes were comparable between the groups (p=0.227). Conclusion Young STEMI patients exhibit a distinct risk profile dominated by modifiable factors and demonstrate reduced thrombolysis success despite timely reperfusion, suggesting a heightened prothrombotic and inflammatory state. These findings underscore the importance of targeted prevention and support consideration of early invasive strategies in younger patients, warranting further large-scale studies.