First Acute Myocardial Infarction (AMI) in the Very Young Versus Older Population: A Clinical and Prognostic Comparison
Md. Ahasanul Haque Razib
Assistant Professor Department of Cardiology Mymensingh Medical College & Hospital Mymensingh, Bangladesh E-mail: razib198629@gmail.com
Abdul Wadud Chowdhury
Professor and Director National Institute of Cardiovascular Diseases Dhaka, Bangladesh
Atif Ramjan Mahmoda
Indoor Medical Officer Department of Obstetrics & Gynaecology Mymensingh Medical College & Hospital Mymensingh, Bangladesh
Keywords: Acute Myocardial Infarction, Young-Adults, Coronary
Artery Disease, and Cardiovascular Risk Factors
Abstract
Background:
South Asians, including Bangladeshis, experience AMI at younger age,
yet local comparative data are limited.
Objective:
This study aimed to compare the very young (≤30 years) versus older
(≥50 years) patients presenting with their first AMI.
Methods:
This cross-sectional comparative study was conducted at Dhaka
Medical College and Hospital from July 2022 to December 2023,
including 160 first-AMI patients, very young (n=80) and older (n=80),
diagnosed by the Fourth Universal Definition (2018).
Results:
Mean age was 26.4±2.8 vs 61.7±7.4 years; male predominance was
higher in the very young (87.5% vs 75.0%, p=0.048). Very young
patients had more smoking (57.5% vs 30.0%, p<0.001) and family
history (42.5% vs 20.0%, p=0.003), while older patients had more
hypertension, diabetes, and dyslipidaemia (all p<0.05). STEMI, higher
LVEF, and single-vessel disease were more frequent in the very young,
whereas triple-vessel disease was more common in older patients.
Older patients had longer stays and higher heart failure, shock, and
mortality (all p<0.05).
Conclusion:
Very young first-AMI patients showed a smoking-dominant,
single-vessel pattern with better in-hospital outcomes; older patients
had cardiometabolic risk clustering, multivessel disease, and worse
prognosis.
J Rang Med Col. March 2026; Vol.11, No.1:9-15
DOI: https://doi.org/10.3329/jrpmc.v11i1.89920