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RISK FACTOR DISTRIBUTION AND LONG-TERM OUTCOMES IN YOUNG PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION IN
Biljana Zafirovska1, Magdalena Otljanska1, Danica Petkoska1
1University Clinic of Cardiology, Faculty of Medicine, University of St Cyril & Methodius, Skopje, Macedonia.
Insights
Young patients undergoing percutaneous coronary intervention (PCI) often have a family history of coronary artery disease (CAD), smoke, or are obese. These young individuals experience excellent long-term survival exceeding 99% post-PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Coronary artery disease (CAD) is increasingly affecting younger populations globally.
- Understanding risk factors and outcomes in young patients undergoing percutaneous coronary intervention (PCI) is crucial for targeted prevention and treatment strategies.
- Limited data exists on the specific profile and long-term prognosis of young PCI patients in Macedonia.
Purpose of the Study:
- To evaluate the distribution of CAD risk factors in young patients (≤40 years) undergoing PCI.
- To compare clinical and procedural characteristics between young and older PCI patients.
- To analyze the long-term outcomes, including major adverse cardiac and cerebrovascular events (MACCE) and mortality, in young PCI patients.
Main Methods:
- Retrospective analysis of 12,361 PCI patients from March 2011 to December 2017 in Macedonia.
- Comparison of a cohort of 309 young patients (≤40 years) with 12,052 older patients (>40 years).
- Assessment of CAD risk factors, clinical presentation, angiographic findings, procedural data, and long-term MACCE and mortality.
Main Results:
- Young PCI patients (≤40 years) were predominantly male (88%) and presented more frequently with ST-segment elevation myocardial infarction (STEMI) (48%).
- Common risk factors in young patients included positive family history for CAD, smoking, and obesity (p<0.0001).
- Long-term follow-up (median 3.5 years) showed low MACCE rates (1.9%) and excellent annual survival (>99%) in young PCI patients.
Conclusions:
- Positive family history, smoking, and obesity are significant risk factors for CAD in young individuals requiring PCI.
- Young PCI patients typically present with single-vessel disease and STEMI, necessitating primary PCI.
- Percutaneous coronary intervention offers an excellent long-term prognosis for young patients with CAD.
Abstract:
The aim was to assess coronary artery disease (CAD) risk factor distribution and long-term outcomes in young patients undergoing percutaneous coronary intervention (PCI) in Macedonia. A total of 12,361 PCI patients (from March 2011 to December 2017) were included in the study. Group 1 included 309 young patients aged ≤40 as the main study group, comparing them to 12,052 older PCI patients (group 2) during the study period. We compared CAD risk factor distribution, clinical and procedure characteristics. Additionally, angiographic data, long-term major adverse cardiac and cerebrovascular events (MACCE) and mortality were analyzed in group 1 patients. Median age was 36±4 years in group 1 and 62±11 years in group 2. Male patients predominated in both groups (88% vs.73%). Positive family history for CAD, smoking and obesity was much more common in the young group (p<0.0001). ST segment elevation myocardial infarction (STEMI) primary PCI was also more frequent with 48% of PCI in the young group (p<0.0001). Multivessel CAD and chronic total occlusion interventions were more common in the older group (51% and 28%, respectively; p<0.0001). Procedure duration (31±0.4 vs. 35±22 min) and fluoroscopy time (9±4 vs. 9±12 min) were similar in both groups. There was no difference in access site bleeding (4.8% vs. 4.3%). During the 3.5-year median follow up, MACCE was present in 1.9% of young patients. In conclusion, positive family history for CAD, obesity and smoking were the most common risk factors in the young PCI population. Young PCI patients usually had single vessel CAD with STEMI being more frequent as the cause for primary PCI. Long-term annual survival exceeded 99% in these patients with excellent prognosis after PCI.
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