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April 28, 1997

Epidemiologic Variables and Outcome of 1972 Young Patients With Acute Myocardial InfarctionData From the GISSI-2 Database

Author Affiliations

for the Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2)

From the Medical Department, Civil Hospital, Lugano, Switzerland (Drs Moccetti, Malacrida, Pasotti, Sessa, and Genoni); and Istituto di Ricerche Farmacologiche M. Negri, Milan, Italy (Ms Barlera and Drs Turazza and Maggioni). A complete list of the investigators and centers participating in GISSI-2 has been published elsewhere.14

Arch Intern Med. 1997;157(8):865-869. doi:10.1001/archinte.1997.00440290049005

Background:  Acute myocardial infarction in younger patients is uncommon, occurring mainly in men. The recent introduction of thrombolysis improved survival, left ventricular function, and infarct size.

Objective:  To evaluate characteristics and clinical outcome of the patients younger than 50 years randomized in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico study. All patients received a thrombolytic treatment.

Methods:  The 11 483 patients were divided into 3 age subgroups: younger than 50 years (17.2%), between 50 and 70 years (60.2%), and older than 70 years (22.6%). All relations between variables were first determined by an unadjusted analysis. An adjusted analysis was performed by multiple logistic regression models for inhospital and 6-month mortality.

Results:  While older patients had a significantly higher rate of a history of hypercholesterolemia, diabetes, and hypertension, smoking and a positive family history were significantly more frequent in younger patients. Total inhospital and 6-month mortality were significantly lower in patients younger than 50 years (2.7% and 1.2%, respectively) than in patients between 50 and 70 years old (6.9% and 2.7%) and those older than 70 years (21.1% and 8.4%). After multivariate analysis, the predictive value of age was confirmed.

Conclusions:  Our findings, based on a large group of patients who received thrombolytic treatment, suggest that younger age is a significant independent indicator of a favorable prognosis after acute myocardial infarction.Arch Intern Med. 1997;157:865-869