A Retrospective Analysis of Characteristics and Outcomes of Young ST-Elevation Myocardial Infarction Patients in the Dubai Population.

Abstract

Background: ST-elevation myocardial infarction (STEMI) is a leading cause of morbidity and mortality, with rising incidence among younger individuals. Conventional risk factors, smoking, diabetes, dyslipidemia, and hypertension, contribute significantly to atherosclerosis, but regional data remain limited. In the UAE, STEMI often presents at a younger age than in Western populations, yet demographic, clinical, and outcome data for this group are still underreported.

Methods: This retrospective study included adults ≤45 years admitted with STEMI to major government hospitals in Dubai (2018-2023). Clinical, demographic, and angiographic data were analyzed. Patients were stratified into low-, intermediate-, and high-risk groups based on left ventricular ejection fraction (LVEF), coronary vessel involvement, and STEMI-related complications. Intergroup comparisons used the Fisher-FreemanHalton exact test and the Kruskal-Wallis test. Associations between risk category and in-hospital outcomes were assessed using Fisher’s exact test (p 0.05). Regional findings were compared with global data to identify population-specific trends.

Results: A total of 461 patients met the inclusion criteria and were stratified by risk group. The cohort was predominantly male (98%) and South Asian (86.3%), with a median age of 40 years. Most had ≥1 cardiovascular risk factor: dyslipidemia (59.7%), smoking (55.5%), diabetes (47.5%), hypertension (33%), and a family history of premature CAD (9.5%). The left anterior descending artery was the most common culprit artery (60.3%), and single-vessel disease predominated (48.8%). Most had an uncomplicated hospital course (84.8%), while 15.2% experienced complications-mainly arrhythmias (10%), followed by death, cardiogenic shock, and others. Risk group distribution was as follows: low (70.1%), intermediate (27.5%), and high (2.4%). Significant associations were found between risk categories and dyslipidemia (p = 0.026), age (p = 0.010), eGFR (p = 0.0125), and factors used in stratification: LVEF and vessel count (p < 0.001). Higher risk groups were linked to an increase in in-hospital complications and death (p < 0.001).

Conclusions: Young adults presenting with STEMI in Dubai tend to exhibit shared demographic and anatomical characteristics. Increasing age and dyslipidemia are associated with a higher likelihood of in-hospital complications and adverse outcomes. While some findings, such as the associations with LVEF, eGFR, and extent of coronary disease, aligned with global data, traditional risk factors like diabetes and hypertension showed no significant associations, possibly reflecting population-specific patterns. Although not directly tested, public health strategies targeting smoking cessation and early detection of lipid disorders may help mitigate the burden of premature STEMI. Further research into genetic and metabolic predispositions is warranted to refine risk assessment and improve preventive efforts in this population.