First Acute Myocardial Infarction (AMI) in the Very Young Versus Older Population: A Clinical and Prognostic Comparison

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.2026 Mar;11(1): 9-15