Evaluation of risk factors, clinical profile, angiographic characteristics and reperfusion therapy among young patients (≤ 45 years) with acute ST-elevation myocardial infarction in comparison to older patients at a tertiary care centre in South India

Introduction Ischaemic heart disease (IHD) remains a leading cause of morbidity and mortality worldwide and poses an increasing public health challenge in India. The rising incidence of myocardial infarction, especially among younger individuals, is concerning.Aim To compare cardiovascular risk factors, clinical presentation, angiographic patterns and reperfusion characteristics between younger and older adults presenting with ST-segment elevation myocardial infarction (STEMI).Methods A cross-sectional analytical study was conducted among 260 patients admitted to a tertiary care hospital in South India with a first episode of STEMI. Participants were selected using convenience sampling and included 65 younger adults (≤45 years) and 195 older adults (>45 years) in a 1:3 ratio. Data were obtained through structured interviews and review of the medical records. Continuous variables were analysed using the Independent Student’s t-test or Mann-Whitney U test, while categorical variables were assessed using the χ 2 or Fisher’s exact test. Univariate and multivariate logistic regression analyses were performed with results reported as ORs and adjusted ORs with 95% CIs.Results The mean age was 40.14±15.79 years in the younger group and 60.84±8.25 years in the older group. Younger patients had a significantly higher male predominance, greater alcohol consumption, positive family history of premature cardiovascular disease, shorter sleep duration and higher anxiety scores. In contrast, older adults have a significantly higher prevalence of hypertension and diabetes mellitus. Multiple logistic regression revealed an increase in average sleep duration was associated with a 0.57-unit increase in the log-odds of being aged >45 years. On the contrary, the anxiety score was inversely associated with older adults (β=−0.10; AOR=0.90; 95% CI 0.82 to 0.99).Conclusion Younger patients with acute STEMI exhibited an increased burden of modifiable lifestyle and psychosocial risk factors, emphasising the need for age-specific preventive interventions.