The following is a summary of “Long-term risk factor management and adverse events in patients with early-onset myocardial infarction—a “real-world” study,” published in the June 2024 issue of Cardiology by Kerniss et al.
Researchers conducted a retrospective study investigating real-world risk factor management and AEs in patients with early-onset myocardial infarction (EOMI), given the scarcity of such data despite existing guidelines emphasizing preventive efforts.
In a German registry study, they examined 301 patients under 45 years old who had MI. The risk factor was evaluated during the initial MI and again after one year. Long-term follow-up (median 49 months) analyzed significant adverse cardiac and cerebrovascular events (MACCE) and factors predicting them.
The results showed that most patients with EOMI had inadequate control of risk factors, even at the 1-year follow-up. After one year, 42% of patients remained smokers, and 74% were physically inactive. Obesity rates rose significantly from the index MI (41%) to the 1-year follow-up (46%, P=0.03), along with increases in dysglycemia (index MI: 40%; 1-year follow-up: 51%, P<0.01) and diabetes mellitus (index MI: 20%; 1-year follow-up: 24%, P<0.01). Among patients with diabetes, 66% had unsatisfactory HbA1c after one year, and 69% did not meet lipid targets recommended by guidelines. The long-term follow-up revealed a MACCE rate of 20% (IR 0.05 per person-year). In a multivariable analysis, smoking (HR 2.2, 95% CI 1.3–3.7, P<0.01) and physical inactivity (HR 2.8, 95% CI 1.2–6.7, P= 0.02) were significant predictors of MACCE occurrence.
Investigators concluded that patients with EOMI often lacked sufficient long-term risk factor control, leading to higher rates of MACCE. This highlights the critical need for improved preventive strategies in this population.
Source: link.springer.com/article/10.1007/s00392-024-02478-3
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