Women Who Experience a Myocardial Infarction at a Young Age Have Worse Outcomes Compared With Men (YOUNG-MI)

Heart attacks in young adults are often assumed to be a male problem, and the care patterns reflect that assumption. The YOUNG-MI registry exposed the cost of it.

Among more than 2,000 patients who had their first heart attack at a young age, women were less likely to undergo invasive procedures and less likely to receive guideline-recommended therapies than men. Despite comparable cardiovascular mortality, women had higher all-cause mortality over long-term follow-up. The disparity in treatment tracked with a disparity in survival.

The finding is part of a broader, well-documented pattern: women’s cardiac disease is under-recognized and under-treated, with measurable consequences. It reinforces that sex must inform how aggressively clinicians evaluate and treat — a theme echoed in the studies on atypical presentations and sex-specific testing.

We rate the evidence moderate-to-strong. As a single-system retrospective registry it has limits on generalizability and confounding, but it adds a clear, clinically important data point to the case that young women with heart disease deserve the same intensity of care as men.