Comparison of outcomes in young versus nonyoung patients with ST elevation myocardial infarction treated by primary angioplasty.
OBJECTIVE
We sought to determine in-hospital and intermediate-term outcomes of primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) in young adults.


METHODS
We reviewed 2424 consecutive patients treated with primary angioplasty for acute MI; 465 were aged 45 or less (young group) and 1959 were 46-74 years of age (nonyoung group). Clinical characteristics, in-hospital and intermediate-term outcomes of primary PCI were analyzed.


RESULTS
Compared with nonyoung patients, the young patients had significantly lower in-hospital and intermediate-term mortality (for in-hospital mortaliy: 5.4 vs. 1.2%, P<0.001; for intermediate-term mortality: 5 vs. 1.3%, P<0.001). By multivariate Cox regression analysis in all 2424 patients; cardiogenic shock, diabetes mellitus, anterior MI and unsuccessful procedure were independent predictors of both in-hospital and intermediate-term mortality whereas age [odds ratio (OR): 1.07, P<0.001], female sex (OR: 1.88, P = 0.04), MI history (OR: 3.05, P = 0.001) and multivessel disease (OR: 2.15, P = 0.01) were independent predictors of only intermediate-term mortality. The young group had lower unsuccessful procedure rates of primary PCI for STEMI (4.9 vs. 10.1%, P = 0.001).


CONCLUSIONS
These results suggest that young adults who underwent primary PCI have favorable in-hospital and intermediate-term outcomes. Moreover, primary PCI for young adults with STEMI is safer, more feasible and effective than for a relatively older population.
Ergelen
Mehmet
M
Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34750, Turkey. drmerg@hotmail.com
Uyarel
Huseyin
H
Gorgulu
Sevket
S
Norgaz
Tugrul
T
Ayhan
Erkan
E
Akkaya
Emre
E
Cicek
Gokhan
G
Isik
Turgay
T
Gunaydin
Zeki Yüksel
ZY
Soylu
Ozer
O
Uğur
Murat
M
Yildirim
Aydin
A
Tezel
Tuna
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome