Background: Myocardial infarction (MI) in young adults, once a rarity, is increasingly recognized as a distinct clinical entity. Unlike traditional MI patients, younger individuals often present without established risk factors or advanced atherosclerosis, prompting a reevaluation of pathophysiologic paradigms and risk assessment strategies. Objective: This review synthesizes current evidence on the epidemiology, pathophysiology, and diagnostic challenges of MI in adults under 55 years, with emphasis on risk factor profiles. We distinguish between traditional cardiovascular risk factors—smoking, dyslipidemia, hypertension, diabetes, obesity, and family history—and emerging contributors, including elevated lipoprotein(a), recreational drug use (cocaine, cannabis, amphetamines), autoimmune and inflammatory conditions, psychosocial stress, sleep disorders, genetic predisposition, and non-atherosclerotic mechanisms such as myocardical infarction with non-obstructive coronary arteries, spontaneous coronary artery dissection, SCAD and Takotsubo syndrome. Methods: A narrative literature review was conducted, focusing on studies from the last five years addressing MI in young adults, including data from large registries, cohort studies, and recent experimental findings.

Multiple sclerosis (MS) is a chronic progressive neurodegenerative disease that leads to disabilities such as difficulty moving and slowed cognitive processing. It is the leading non-traumatic cause of disability worldwide. MS also has a high potential to become a model for neurodegenerative diseases with a progression like Alzheimer’s or Parkinson’s. Cardiovascular diseases (CVDs) remain the leading cause of global deaths and have a considerable economic impact. The higher incidence of cardiovascular comorbidities in patients with MS compared to healthy individuals of the same age worsens the prognosis of neurological pathology, leading to a higher level of disability, poorer physical outcomes, higher depression scores, cognitive aging, and diminished quality of life. Classical observational studies often have questionable elements that can represent a source of error, making it difficult to establish a causal relationship between MS and CVD. Genetic studies, including genome-wide evaluation, may resolve this issue and may represent a topic for future research. We report the case of a 31-year-old male patient with a history of multiple sclerosis (MS) diagnosed seven years prior, who presented with acute chest pain upon returning from vacation. Despite the previous recommendation for disease-modifying therapy, the patient had discontinued treatment by personal choice. Electrocardiography (ECG) revealed ST-segment elevation in inferior leads, and emergent coronary angiography identified severe multi-vessel coronary artery disease (CAD), requiring immediate revascularization. This case highlights the potential cardiovascular risks in young patients with MS and the importance of continuous medical supervision.

Background: The incidence of acute myocardial infarction (AMI) in young adults has been steadily rising, emphasizing the need for new biomarkers to improve risk stratification. Lipoprotein(a) (Lp(a)), a genetically determined lipoprotein with pro-atherogenic and pro-thrombotic properties, has gained increasing attention in this context. Methods: We evaluated serum Lp(a) levels in young patients with AMI and compared them with healthy controls. Associations between elevated Lp(a) levels (≥30 mg/dL) and coronary artery disease patterns were analyzed separately for STEMI and NSTEMI presentations. Results: Elevated Lp(a) levels were significantly more common in young patients with AMI compared with healthy controls. Importantly, Lp(a) ≥ 30 mg/dL was strongly associated with multivessel coronary artery disease in NSTEMI, conferring more than a fourfold increased risk. In STEMI, the effect was weaker and largely influenced by concomitant factors such as diabetes and elevated LDL cholesterol. Conclusions: These findings highlight key pathophysiological differences between infarct phenotypes and position Lp(a) as a particularly relevant biomarker in young NSTEMI patients. The systematic assessment of Lp(a) may enhance coronary risk stratification and support more tailored secondary prevention strategies.

Background: Myocardial infarction (MI) in young adults, once a rarity, is increasingly recognized as a distinct clinical entity. Unlike traditional MI patients, younger individ-uals often present without established risk factors or advanced atherosclerosis, prompt-ing a reevaluation of pathophysiologic paradigms and risk assessment strategies. Objective: This review aims to synthesize recent evidence on the epidemiology, tradi-tional and emerging risk factors, pathophysiological mechanisms, and diagnostic chal-lenges of MI in individuals under 55, with emphasis on the unique features of this population. Methods: A narrative literature review was conducted, focusing on studies from the last five years addressing MI in young adults, including data from large registries, cohort studies, and recent experimental findings.

The incidence of acute myocardial infarction (AMI) in young adults has been steadily rising, emphasizing the need for new biomarkers to improve risk stratification. Lipo-protein(a) (Lp(a)), a genetically determined lipoprotein with pro-atherogenic and pro-thrombotic properties, has gained increasing attention in this context. Our findings show that elevated Lp(a) levels are significantly more common in young patients with AMI compared with healthy controls. Importantly, Lp(a) ≥30 mg/dL was strongly associated with multivessel coronary artery disease in NSTEMI, conferring more than a fourfold increased risk. In STEMI, its effect was weaker and largely influenced by concomitant factors such as diabetes and elevated LDL cholesterol. These results underline key pathophysiological differences between infarct phe-notypes and position Lp(a) as a particularly relevant biomarker in young NSTEMI pa-tients. Systematic assessment of Lp(a) may enhance coronary risk stratification and support more tailored secondary prevention strategies.

Background and Objectives: Although acute myocardial infarction (AMI) is traditionally regarded as a disease of older age, its rising incidence in younger patients challenges age-based assumptions regarding in-hospital management and prognosis. Length of hospital stay is a critical marker of disease complexity and healthcare burden, yet its determinants across age groups remain insufficiently characterized. Materials and Methods: We retrospectively analyzed 200 consecutive patients admitted with ST-segment eleva-tion myocardial infarction (STEMI), stratified by age (< 45 vs. >45 years). Clinical, bio-logical, echocardiographic, and angiographic parameters were assessed. Prolonged hospitalization was defined as a hospital stay exceeding 7 days. Independent predictors were identified using multivariable logistic regression. Results: Despite marked differences in risk profiles and coronary anatomy between age groups, chronological age was not an independent determinant of hospitalization duration. Di-abetes mellitus and left anterior descending artery involvement were independently associated with prolonged hospital stay, whereas percutaneous coronary intervention significantly reduced hospitalization duration. Conclusions: In STEMI, hospitalization burden is shaped by comorbidity burden and revascularization strategy rather than age itself. These findings challenge age-centered clinical paradigms and support an individualized, mechanism-driven approach to in-hospital management aimed at reducing hospitalization duration and resource utilization.