الفهرس 
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Abstract
A
cute ST-elevation myocardial infarction (STEMI) is a disease of the elderly population; however. In Egypt, there is increasing number of STEMI cases among youth who have unique characteristics that differ from old patients.
The aim of the study was to establish a prospective registry for young adults < 40 years old presenting with STEMI and undergoing primary PCI to investigate the risk profile and angiographic findings in those patients and to compare them with the old patients >40 years old.
We studied 235 patients admitted to Ain Shams university hospitals with STEMI. They were divided into 2 groups >40 and ≤40 years, the risk profile and angiographic findings were compared in both groups.
The male gender was predominantly affected at the young age group. Smoking was prevalent in both age groups. The old group had higher prevalence of diabetes (P<0.01), hypercholesterolemia (P 0.015) and renal impairment (P 0.009), while young patients were more likely to be drug addicts (P<0.001) and to have a family history of premature CAD (P<0.001). Peak total CK and CKMB were significantly higher in young group (P 0.015, P 0.016 respectively). Anterior STEMI was significantly higher in young population (P 0.049) while inferior STEMI was higher in old group (P 0.042). MINOCA was exclusively found in young group (P < 0.0001). Culprit LAD lesion was higher in the young group (P 0.016). Independent predictors of STEMI in the young group were drug addiction (OR 8.8 P 0.0001) and family history of premature CAD (OR 12.4 P 0.0001).
In conclusion, acute STEMI in young Egyptians was predominantly observed in men, smoking was the most common risk factor like in old patients. However, youth have unique risk profile and angiographic findings. They tend to be drug addicts and to have positive family history of premature CAD with less diabetes or hypercholesterolemia. They have less extensive CAD, with anterior STEMI as the most common presentation and LAD as the most common culprit territory.