Abstract 245 Secondary prevention in very young patients with myocardial infarction: Are risk factor targets achieved after one year?

Background

Cardiovascular prevention in young patients with myocardial infarction (MI) is of extraordinary importance due to long life expectancy and socioeconomic responsibilities of patients. In this study, we investigated whether patients with MI ≤ 45 years are adequately controlled over long-term.

Methods

All consecutive patients ≤ 45 years with MI who were admitted to an overregional heart center between 2015 and 2021 were included in the analysis. Patients were personally revisited one year after MI to assess clinical events and risk factor control.

Results

Out of 214 patients ≤ 45 years with follow-up visit one year after MI, the majority did not achieve guideline-recommended risk factor targets during the long-term: The rate of patients with body mass index ≥30 kg/m2 increased significantly from hospital discharge (n=89, 42%) to one-year follow-up (n=98, 46%, p=0,04). Most patients reported that they were not physically active, 148 patients (69%) performed leisure-time exercise less than 3 days per week. 88 patients (41%) were persistent smokers at one-year follow-up. 151 patients (71%) didn't attain the lipid levels recommended by the valid international guidelines. 87% of the young patients after MI were on a single lipid-lowering therapy at one-year follow-up (73% of those did not reach the lipid targets), while only 10 patients were on dual lipid-lowering therapy (50% of those were on target). A significant increase of patients with dysglycemia (HbA1c ≥5.7%) (discharge: n=86, 40%; one-year follow-up: n=99, 46%, p<0,01) as well as diabetes mellitus (discharge: n=39, 18%; one-year follow-up: n=51, 24%, p<0,01) was observed over time. Only 35% of the diabetics had HbA1c ≥8.0% after 1 year. 21 patients (41%) with known diabetes had no HbA1c monitoring during one-year follow-up.

Conclusion

In this study on young patients with MI inadequate risk factor control with even a worsening tendency at long-term visit after one year was observed. Considering these data, prevention efforts should be intensified and prevention programs to improve risk factor control in these patients are crucially needed.

Figure: Risk factor control in patients ≤45 years with MI at discharge and one-year follow-up.

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Secondary prevention in very young patients with myocardial infarction: Are risk factor targets achieved after one year?
H. Kerniss¹, L. A. Mata Marín¹, A. Seidel¹, S. Alo¹, S. Rühle¹, J. Schmucker¹, R. Osteresch¹, A. Fach¹, R. Hambrecht¹, H. Wienbergen¹
¹Bremer Institut für Herz- und Kreislaufforschung (BIHKF), Bremen;
Background Cardiovascular prevention in young patients with myocardial infarction (MI) is of extraordinary importance due to long life expectancy and socioeconomic responsibilities of patients. In this study, we investigated whether patients with MI ≤ 45 years are adequately controlled over long-term. Methods All consecutive patients ≤ 45 years with MI who were admitted to an overregional heart center between 2015 and 2021 were included in the analysis. Patients were personally revisited one year after MI to assess clinical events and risk factor control. Results Out of 214 patients ≤ 45 years with follow-up visit one year after MI, the majority did not achieve guideline-recommended risk factor targets during the long-term: The rate of patients with body mass index ≥30 kg/m2 increased significantly from hospital discharge (n=89, 42%) to one-year follow-up (n=98, 46%, p=0,04). Most patients reported that they were not physically active, 148 patients (69%) performed leisure-time exercise less than 3 days per week. 88 patients (41%) were persistent smokers at one-year follow-up. 151 patients (71%) didn't attain the lipid levels recommended by the valid international guidelines. 87% of the young patients after MI were on a single lipid-lowering therapy at one-year follow-up (73% of those did not reach the lipid targets), while only 10 patients were on dual lipid-lowering therapy (50% of those were on target). A significant increase of patients with dysglycemia (HbA1c ≥5.7%) (discharge: n=86, 40%; one-year follow-up: n=99, 46%, p<0,01) as well as diabetes mellitus (discharge: n=39, 18%; one-year follow-up: n=51, 24%, p<0,01) was observed over time. Only 35% of the diabetics had HbA1c ≥8.0% after 1 year. 21 patients (41%) with known diabetes had no HbA1c monitoring during one-year follow-up. Conclusion In this study on young patients with MI inadequate risk factor control with even a worsening tendency at long-term visit after one year was observed. Considering these data, prevention efforts should be intensified and prevention programs to improve risk factor control in these patients are crucially needed. Figure: Risk factor control in patients ≤45 years with MI at discharge and one-year follow-up.
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