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[Clinical profile of patients aged 40 and younger undergoing coronary artery bypass grafting]
Bartłomiej Perek1, Marek Jemielity, Tomasz Urbanowicz
1Klinika Kardiochirurgii, Akademii Medycznej w Poznaniu.
Insights
Younger patients (≤40 years) undergoing coronary artery bypass grafting (CABG) show higher rates of risk factors like smoking and obesity. Despite less prominent atherosclerosis, they experience more frequent impaired left ventricular function.
Area of Science:
- Cardiology
- Vascular Surgery
- Public Health
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for severe coronary artery disease.
- Risk factor prevalence and disease severity can vary significantly with patient age.
- Understanding these differences is crucial for optimizing patient care and outcomes.
Purpose of the Study:
- To compare the prevalence of atherosclerosis risk factors and disease severity in patients aged 40 or younger versus older patients undergoing CABG.
- To identify age-specific patterns in risk factors and clinical presentation for patients requiring CABG.
Main Methods:
- A retrospective analysis of 2282 patients who underwent isolated CABG between 1997 and 2003.
- Patients were categorized into three age groups: ≤40 years (Group A), 41-65 years (Group B), and >65 years (Group C).
- Data collected included prevalence of atherosclerosis risk factors and assessment of coronary artery disease severity and left ventricular function.
Main Results:
- Patients aged 40 or younger (Group A) exhibited a higher incidence of active smoking (38.5%), hypercholesterolemia (92.3%), positive family history of coronary artery disease (51.3%), and obesity (38.5%) compared to older groups.
- Younger patients were more frequently diagnosed with single-vessel disease (20.5%).
- Despite potentially less advanced coronary disease, Group A showed a significantly higher rate of impaired left ventricular systolic function (ejection fraction <40%) (35.9%) compared to older groups.
Conclusions:
- Patients aged 40 or younger undergoing CABG present with a greater burden of traditional cardiovascular risk factors.
- Although coronary atherosclerosis may be less advanced in younger individuals, they are more likely to have compromised left ventricular function at the time of surgery.
- These findings highlight the need for tailored risk factor management and assessment of cardiac function in younger patients requiring CABG.
Aim Of Study:
To compare the prevalence of risk factors and severity of atherosclerosis in patients (pts) aged 40 or younger undergoing coronary artery bypass grafting (CABG) in comparison to older pts.
Material And Methods:
Retrospective study involved consecutive 2282 pts, who underwent isolated CABG between 1997 and 2003. Pts were divided into three groups: group A--pts aged 40 years or younger (n=39), group B--aged 41 to 65 (n=1497) and group C--aged over 65 years (n=746). All pts were analyzed for prevalence of atherosclerosis risk factors and severity of atherosclerosis.
Results:
Pts in group A had a higher incidence of active smoking (38.5 vs 18.1 vs 13.0%, for group A, B and C respectively; p < 0.001), hypercholesterolemia (92.3 vs 72.1 vs 66.2%; p < 0.05), positive family history of coronary artery disease (51.3 vs 25.1 vs 8.3%; p < 0.001) and obesity (38.5 vs 32.5 vs 22.8%; p < 0.05). Pts in group A were qualified for surgery more often with single-vessel disease (20.5 vs 2.9 vs 4.2%; p < 0.001). In the spite of this fact, significant impairment of left ventricular systolic performance was noted more frequent in group A (ejection fraction below 40%) (35.9 vs 17.4 vs 13.8%, in group A, B and C respectively; p < 0.05).
Conclusions:
Compared with the older populations, pts aged 40 or younger undergoing CABG had a higher incidence of active smoking, hypercholesterolemia, positive family history of CAD and obesity. Although atherosclerosis of the coronary arteries is less prominent in young pts, more often it is accompanied by markedly impaired left ventricular function.
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