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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Feb 26, 2026; 18(2): 116172
Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.116172
Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.116172
Non-traditional risk factors for myocardial infarction in adults under forty: A systematic review of emerging trends
Tirath Patel, Department of Medicine, Trinity Medical Sciences University School of Medicine, Kingstown VC0100, Saint George, Saint Vincent and the Grenadines
Muhammad Farhan, Internal Medicine, Ajman University, Ajman 6263, United Arab Emirates
Nehal K Bhatt, Department of Medicine, Pramukhswami Medical College, Gujarat 380001, India
Hewaz A Fatah, Internal Medicine, Turaq Primary Healthcare Centre, General Directorate of Health, Erbil 44001, Arbīl, Iraq
Joel J Peniel, Internal Medicine, Tbilisi State Medical University, Tbilisi 0144, Georgia
Ved V Kaulgud, Aashita M Bapat, Internal Medicine, Hinduhrudaysamrat Balasaheb Thackrey Medical College, Mumbai 400005, Mahārāshtra, India
Tisimol Mathew, Internal Medicine, Davao Medical School Foundation, Davao 8016, Philippines
Waleed SS Harazeen, Abdullatif N Alatta, Internal Medicine, Ajman University, College of Medicine, Ajman 6263, United Arab Emirates
Ayoola Awosika, Department of Family Medicine, University of Illinois College of Medicine Peoria, Bloomington, IL 61601, United States
Author contributions: Patel T, Farhan M, Mathew T, and Awosika A were responsible for conceptualization; Patel T and Farhan M designed the work; Patel T and Awosika A undertook data acquisition and conducted data analysis; Farhan M, Kaulgud VV, and Bapat AM participated in article screening; Bhatt NK carried out literature review, data extraction and discussion development; Fatah HA and Harazeen WSS performed quality assessment; Fatah HA refined methodology; Peniel JJ interpreted data and reviewed the manuscript, conducted risk-of-bias assessment, data synthesis and wrote the results section; Kaulgud VV managed references and prepared figures; Mathew T wrote and reviewed the introduction and discussion sections; Bapat AM conducted formal analysis and contributed to the first draft; Harazeen WSS contributed to the original draft and did review and editing; Alatta AN prepared tables, participated in methodology work and discussion development; Patel T, Bapat AM, Awosika A, and Harazeen WSS contributed to writing the first draft; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ayoola Awosika, MD, Department of Family Medicine, University of Illinois College of Medicine Peoria, 1 Illini Drive, Bloomington, IL 61601, United States.
Received: November 4, 2025
Revised: November 14, 2025
Accepted: January 4, 2026
Published online: February 26, 2026
Processing time: 97 Days and 2.5 Hours
Revised: November 14, 2025
Accepted: January 4, 2026
Published online: February 26, 2026
Processing time: 97 Days and 2.5 Hours
Core Tip
Core Tip: Non-traditional risk factors such as psychosocial stressors, autoimmune disorders, biological aging and specific lifestyle and environmental exposures play a significant role in myocardial infarction risk and outcome among individuals aged < 40 years. Psychosocial factors like depression, low socioeconomic status, and unpartnered status were significantly associated with adverse events, especially among young women. Autoimmune diseases and inflammation indicators, as well as sleep disorders and unhealthy lifestyle patterns, additionally improved the risk.