Risk factors profile of young and older patients with myocardial infarction

Marios Sagris, Alexios S. Antonopoulos, Panagiotis Theofilis, Evangelos Oikonomou, Gerasimos Siasos, Sotirios Tsalamandris, Charalambos Antoniades, Emmanouil S. Brilakis, Juan C. Kaski, Dimitris Tousoulis

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Myocardial infarction (MI) among young adults (<45 years) represents a considerable proportion of the total heart attack incidents. The underlying pathophysiologic characteristics, atherosclerotic plaque features, and risk factors profile differ between young and older patients with MI. This review article discusses the main differences between the younger and elderly MI patients as well as the different pathogenic mechanisms underlying the development of MI in the younger. Young patients with MI often have eccentric atherosclerotic plaques with inflammatory features but fewer lesions, and are more likely to be smokers, obese, and have poor lifestyle, such as inactivity and alcohol intake. Compared to older MI patients, younger are more likely to be men, have familial-combined hyperlipidaemia and increased levels of lipoprotein-a. In addition, MI in younger patients may be related to use of cannabis, cocaine use, and androgenic anabolic steroids. Genomic differences especially in the pathways of coagulation and lipid metabolism have also been identified between young and older patients with MI. Better understanding of the risk factors and the anatomic and pathophysiologic processes in young adults can improve MI prevention and treatment strategies in this patient group. Awareness could help identify young subjects at increased risk and guide primary prevention strategies. Additional studies focusing on gene pathways related to lipid metabolism, inflammation, and coagulation are needed.

Original languageEnglish (US)
Pages (from-to)2281-2292
Number of pages12
JournalCardiovascular Research
Volume118
Issue number10
DOIs
StatePublished - Jul 27 2022

Keywords

  • Atherosclerotic plaque features
  • Genetic factors
  • Myocardial infarction
  • Risk factors
  • Young patients

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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