Young Patients Presenting With Suspected ST-Elevation Myocardial Infarction Undergoing Emergency Coronary Angiography: Clinical Characteristics and 1-Year Outcomes

Objective: This study aimed to determine the demographic and clinical profiles, cardiovascular risk factors, and variables independently associated with major adverse cardiovascular events (MACE) during 1-year follow-up in young patients aged 45 years or younger who presented with suspected ST-segment elevation myocardial infarction (STEMI) and underwent emergency coronary angiography.
Method: This retrospective, single-center, observational study included 126 young patients presenting with suspected STEMI who underwent primary coronary angiography and/or percutaneous coronary intervention at a high-volume tertiary cardiovascular center between January 2021 and April 2025. Patients were classified into two groups according to the occurrence of MACE during 1-year follow-up: the MACE group (n=28) and the non-MACE group (n=98). HbA1c levels were assessed based on a single measurement obtained during the index MI admission. Logistic regression analyses were performed to identify variables independently associated with MACE.
Results: The median age of the overall cohort was 40 years (38–42), and 7.9% of the patients were female. During follow-up, MACE occurred in 22.2% of the patients. The all-cause mortality rate was 4.0%. Multivariable logistic regression analysis demonstrated that higher HbA1c levels (aOR: 1.57; 95% CI: 1.10–2.24; p=0.014), a history of CAD (aOR: 3.93; 95% CI: 1.15–13.37; p=0.029), and lower LVEF (aOR: 0.94; 95% CI: 0.88–0.99; p=0.029) were independently associated with MACE. Notably, among patients without previously known diabetes, HbA1c levels ≥6.5% were significantly associated with an increased risk of MACE.
Conclusion: Young patients presenting with suspected STEMI who undergo emergency coronary angiography may have a notable risk of MACE during the first year of follow-up. A history of CAD, lower LVEF, and elevated HbA1c levels appear to be associated with adverse clinical outcomes.

Keywords: HbA1c, major adverse cardiovascular events, premature coronary artery disease, young STEMI.