Risk factors and predictors of hospital complications of myocardial infarction in young patients

To identify risk factors and predictors of hospital complications of myocardial infarction in young patients.

Materials and Methods. The prospective study included 130 young patients aged 18 to 44 years with ST-segment elevation myocardial infarction who underwent endovascular revascularization. The average age was 38.9 ± 5.4 years. All patients included in the prospective study underwent conventional clinical, instrumental, and laboratory examinations, which included the collection of anamnestic data, physical examinations, and a set of laboratory tests, including high-sensitivity troponin I (TnI), complete blood count, biochemical blood test, and N-terminal fragment of brain natriuretic peptide (NT-pro-BNP). Patients underwent echocardiography and coronary angiography. Contrast-enhanced cardiac magnetic resonance imaging was performed 3–5 days after the endovascular intervention.

Results. Factors associated with the development of life-threatening complications at the hospital stage of treatment in young patients with MI were: pre-revascularization TIMI flow grade 0–1; thrombosis of the proximal segment of the left anterior descending artery; absence of collateral circulation and intermediate coronary stenoses, time to reperfusion, Killip class III–IV heart failure.

Risk factors and predictors of hospital heart failure development in young patients were: the time interval from the onset of pain syndrome to reperfusion; the presence of microvascular obstruction and intramyocardial hemorrhage on MRI; smoking; multivessel coronary artery disease, and CKD. The NT-proBNP level and the peak troponin I level were independent predictors of all complications during the hospital stage of treatment.

Conclusion. Risk factors and predictors associated with the development of life-threatening complications and the progression of heart failure during the hospital stage of treatment in young patients with ST-segment elevation myocardial infarction have been developed.

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