title: Long-term outcomes of percutaneous coronary interventions with stent implantation in patients ≤40 years old.
abstract: Data on the long-term prognosis of percutaneous coronary intervention (PCI) in young patients are limited. The aim of the present study was to report the immediate and long-term clinical outcomes in a consecutive series of young patients with premature coronary artery disease who underwent PCI with stent implantation. During the study period (2005 to 2010), 214 consecutive patients aged ≤40 years who had undergone PCI with a bare metal stent or drug-eluting stent implantation were retrospectively selected and analyzed. Primary end point of this study was the incidence of major adverse cardiac and cerebrovascular events at short- and long-term follow-up. Mean age was 36.3 ± 3.5 years and 88.3% of patients were men. Three-quarters were active smokers and all patients had ≥1 conventional cardiovascular risk factor. The total number of implanted stents was 272 (154 bare metal stent and 118 drug-eluting stent). During the hospital stay, no patient died, and the incidence of major adverse cardiac and cerebrovascular events was 2.3%. No additional events had occurred at 30 days of follow-up. At a median follow-up of 757 days (interquartile range 365 to 1,818), the overall death rate was 0.9%, and a new revascularization procedure was needed in 12.6% of patients. The major adverse cardiac and cerebrovascular event-free survival rate at the median follow-up point and 1,818 days was 89.6% and 84.2%, respectively. Active smoking and left ventricular ejection fraction <50% were independent predictors of major adverse cardiac and cerebrovascular events. In conclusion, PCI in young patients lead to excellent results in short- and long-term follow-up and should be considered as the treatment of choice. Traditional risk factors are important prognostic determinants of adverse events and might help identify higher risk patients within this cohort.
authors.affiliation: Interventional Cardiology Unit, Mauriziano Hospital, Turin, Italy. emeliga@gmail.com
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.forename: Mauro
authors.initials: M
authors.lastname: De Benedictis
authors.forename: Andrea
authors.initials: A
authors.lastname: Gagnor
authors.forename: Riccardo
authors.initials: R
authors.lastname: Belli
authors.forename: Innocenzo
authors.initials: I
authors.lastname: Scrocca
authors.forename: Primiano
authors.initials: P
authors.lastname: Lombardi
authors.forename: Federico
authors.initials: F
authors.lastname: Conrotto
authors.forename: Tiziana
authors.initials: T
authors.lastname: Aranzulla
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Varbella
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Conte
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome