Coronary atherosclerosis begins early in life, but acute coronary syndromes in adults aged <35 years are rare. We aimed to investigate the rate of occurrence, clinical and angiographic characteristics, and in-hospital clinical outcome of STEMI in young patients who were referred to our cardiology departement.

From 2003 to 2013, data of all patients with STEMI aged <35 years were retrospectively retrieved from our database. Baseline, procedural characteristics, and clinical outcome were analyzed. In 2013 we prospectly analyzed the causal lesion with a systematic coronary angiogram and a comparison between patients in whom an underlying atypical aetiology was found (non-ATS group; ATS: atherosclerosis) and patients in whom no such aetiology was detected (ATS group).

A total of 98 young patients with STEMI aged <35 years were admitted during the study period. They accounted for 1.94% of all STEMI admitted. Mean patient age was 28.7±4.7 years and 93 patients (95%) were men. Current smoking (77%) and dyslipidaemia (43%) were the most frequent risk factors. Typical chest pain (n = 90; 92%) and inferior ST-segment elevation myocardial infarction (n=67; 68%) were most often found. Cannabis intoxication was the most frequently encountered atypical aetiology (n=11; 11.2%). In 2013 the ATS group consisted of 4 patients (57%) and the non-ATS group of 3 patients (43%). In-hospital clinical outcome, mortality and complications rate were 2% and 5.1%, respectively.

STEMI in young patients is an uncommon condition with a variety of possible aetiologies and distinct risk factors. In-hospital outcome is satisfactory.