Savic, Lidija (16507811000)Lidija (16507811000)SavicMrdovic, Igor (10140828000)Igor (10140828000)MrdovicAsanin, Milika (8603366900)Milika (8603366900)AsaninStankovic, Sanja (7005216636)Sanja (7005216636)StankovicLasica, Ratko (14631892300)Ratko (14631892300)LasicaKrljanac, Gordana (8947929900)Gordana (8947929900)KrljanacSimic, Damjan (58010380500)Damjan (58010380500)SimicMatic, Dragan (25959220100)Dragan (25959220100)Matic2025-06-122025-06-122024https://doi.org/10.3390/jpm14030231https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188995749&doi=10.3390%2fjpm14030231&partnerID=40&md5=adf70adb9a2dc69fbf393893db7a9f46https://remedy.med.bg.ac.rs/handle/123456789/1256Background: A significant percentage of younger patients with myocardial infarction have premature coronary artery disease (CAD). The aims of this study were to analyze all-cause mortality and major adverse cardiovascular events (MACEs cardiovascular death, non-fatal reinfarction, stroke, target vessel revascularization) during eight-year follow-up in patients with ST-elevation myocardial infarction (STEMI) and premature CAD. Method: We analyzed 2560 STEMI patients without previous CAD and without cardiogenic shock at admission who were treated with primary PCI. CAD was classified as premature in men aged <50 years and women <55 years. Results: Premature CAD was found in 630 (24.6%) patients. Patients with premature CAD have fewer comorbidities and better initial angiographic findings compared to patients without premature CAD. The incidence of non-fatal adverse ischemic events was similar to the incidence in older patients. Premature CAD was an independent predictor for lower mortality (HR 0.50 95%CI 0.28–0.91) and MACEs (HR 0.27 95%CI 0.15–0.47). In patients with premature CAD, EF < 40% was the only independent predictor of mortality (HR 5.59 95%CI 2.18–8.52) and MACEs (HR 4.18, 95%CI 1.98–8.13). Conclusions: Premature CAD was an independent predictor for lower mortality and MACEs. In patients with premature CAD, EF < 40% was an independent predictor of eight-year mortality and MACEs. © 2024 by the authors.predictorspremature coronary artery diseaseprognosisST-elevation myocardial infarction