Long-Term Outcome of Acute Coronary Syndromes in Young Patients

Giacomo Tini, Giulia Proietti, Matteo Casenghi, Marzia Colopi, Katia Bontempi, Camillo Autore, Massimo Volpe, Beatrice Musumeci

Research output: Contribution to journalArticlepeer-review


Introduction: Acute coronary syndromes (ACS) in young patients are uncommon and their influence on morbidity and mortality in this population is still debated. Aim: We investigated clinical and angiographic characteristics, risk factors and outcome in young patients diagnosed with ACS, compared with those of older patients, evaluating survival free from death and/or nonfatal myocardial infarction (MI) and/or coronary revascularization (primary endpoint), and then with respect to each component of the primary endpoint. Methods: We retrospectively analyzed 1696 patients diagnosed with ACS between 2007 and 2013. 116 were aged ≤45 years (young adults), 1116 were >45 and <75 years (older adults) and 464 were ≥75 years. Results: Young adults were mostly male, with a prevalent diagnosis of STEMI, had less frequently typical cardiovascular risk factors and lower prevalence of extensive coronary artery disease. Over a median 3 years follow up, survival free from composite endpoint was better in young than in older adult patients (11.2 vs. 24.2%; p = 0.001), mainly due to a lower rate of death while the occurrence of non fatal MI and of coronary revascularization was similar (7.8 vs. 8.7%, p = 0.86; 8.7 vs. 12.9%, p = 0.23 respectively). Diabetes was the strongest independent risk factor of worse prognosis in the young cohort (OR 3.47; 95% CI 1.01–11.9; p = 0.04). Conclusions: Young adults showed peculiar clinical features and lower mortality compared with older adults. Morbidity was not different between the two populations, with diabetes independently associated with a worse prognosis.

Original languageEnglish
Pages (from-to)77-84
Number of pages8
JournalHigh Blood Pressure and Cardiovascular Prevention
Issue number1
Publication statusPublished - Mar 1 2017


  • Acute coronary syndromes
  • Diabetes
  • Myocardial infarction
  • Outcome
  • Young

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine


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