Determinants of Adverse Outcomes after Myocardial Infarction in Young Patients: A Clinico-Metabolic and Structural Analysis

D. A. Alimov¹, B. F. Mukhamedova¹, M. Kh. Nazarova¹, B. O. Kazakov^1, , N. F. Berdiev¹ and M. R. Kazakova²

¹Republican Research Centre of Emergency Medicine, Tashkent, Uzbekistan

²Tashkent State Medical University

Cite this paper:
D. A. Alimov, B. F. Mukhamedova, M. Kh. Nazarova, B. O. Kazakov, N. F. Berdiev and M. R. Kazakova. Determinants of Adverse Outcomes after Myocardial Infarction in Young Patients: A Clinico-Metabolic and Structural Analysis. American Journal of Medical Sciences and Medicine. 2026; 14(1):13-16. doi: 10.12691/ajmsm-14-1-3

Abstract

Background. Myocardial infarction (MI) in young individuals is an increasingly recognized clinical problem associated with distinct risk factors and prognostic features. Aim. To evaluate clinical, metabolic, and structural-functional characteristics of MI in young patients and to identify predictors of adverse cardiovascular outcomes. Material and methods. A prospective cohort study included 108 young patients (18–45 years) with confirmed MI and 35 older patients (60–75 years). Clinical, laboratory, echocardiographic, and angiographic parameters were assessed at baseline and during a 12-month follow-up. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including cardiovascular death, recurrent MI, unstable angina, and revascularization. Receiver operating characteristic (ROC) analysis and Kaplan–Meier survival analysis were performed. Results. Young patients were predominantly male (85.2%) and more frequently presented with ST-elevation MI (84.3%). Smoking was significantly more prevalent among young patients compared to older individuals (70.2% vs 20.6%, p<0.001), along with a higher prevalence of family history of early coronary artery disease. In contrast, hypertension and type 2 diabetes were more common in older patients. Coronary angiography demonstrated a higher prevalence of single-vessel disease in young patients (48.9% vs 26.7%, p=0.033), whereas multivessel disease predominated in the elderly group. At 12 months, MACE occurred in 24% of young patients, with a mortality rate of 3%. ROC analysis showed good predictive performance of selected parameters (AUC >0.70), while Kaplan–Meier analysis revealed significantly lower event-free survival in high-risk patients. Smoking, hypertension, and increased platelet aggregation were identified as independent predictors of adverse outcomes. Conclusion. Young MI patients exhibit a distinct clinical profile characterized by a high prevalence of modifiable risk factors and predominantly single-vessel coronary disease. Despite relatively favorable baseline characteristics, they remain at substantial risk of adverse cardiovascular outcomes. Aggressive risk factor modification and personalized long-term management strategies are essential to improve prognosis.

Keywords:
Myocardial infarction young patients prognosis risk factors ROC curve Kaplan–Meier cardiovascular outcomes

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