Comparison of factors associated with ST-segment elevation myocardial infarction (STEMI) complications in young versus older adults: A post hoc analysis of a single-centre registry

Abstract

Context and objective. The impact of age on coronary artery disease prognosis is debated. This study compared acute complications in younger (≤55 years) and older (>55 years) ST-segment elevation myocardial infarction (STEMI) patients. Methods. A post hoc analysis of demographics, cardiovascular risk factors (CVRF), clinical, echocardiographic, and coronary angiography data for STEMI patients was carried out. Multivariate logistic regression analysis identified factors associated with complications in each group. Results. Three hundred fifteen data of STEMI patients were analyzed. Smoking and hypertension were the main CVRF in younger and older patients, respectively. Arrhythmias and acute heart failure (AHF) were the most common complications, with AHF more prevalent in the elderly. In younger, arrhythmias risk was associated with peripheral arterial disease (aOR, 3.84), high atherogenic coefficient (aOR, 2.49), and atherogenic index of plasma (aOR, 2.42). In older patients, it was associated with diabetes mellitus (aOR, 3.05), ischemic heart disease (aOR, 1.79), and Castelli Risk Index I (aOR, 2.07). Smoking, elevated hs-CRP, and atherogenic coefficient increased AHF risk in both groups, while atherogenic index of plasma (aOR, 4.34) increased it only in younger patients. Conclusion. The present study reveals distinct CVRF profiles and complications in younger versus older STEMI patients. Some AHF risk factors overlap, while arrhythmia determinants vary, suggesting age-specific treatment protocols.Keywords: ST Segment Elevation Myocardial Infarction (STEMI), Elderly Patients, Young Patients, complications, Coronary Angiography Received: February 1st, 2025Accepted: April 16th, 2025 https://dx.doi.org/10.4314/aamed.v18i3.7