title: Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients.
abstract: BACKGROUND
  Coronary artery disease is most common in older patients, but may occur in younger subjects. The outlook of young patients after percutaneous coronary intervention (PCI) of challenging lesion subsets such as coronary bifurcations, is not established. We thus aimed to appraise the early and long-term results of PCI for bifurcations in young patients.
  
  
  METHODS
  A multicenter, retrospective study was conducted enrolling consecutive patients undergoing bifurcation PCI between 2002 and 2006 in 22 Italian centers. Patients were divided in 2 groups: age ≤ 45 years, and age > 45 years. The primary end-point was long-term rate of major adverse cardiac events (MACE).
  
  
  RESULTS
  4,314 patients were included: 195 (4.5%) in the younger group, and 4119 (95.5%) in the older group. 30-day outcomes did not show significant differences in MACE rates, with 1.0% in the ≤ 45 years group and 2.1% in the >45 years group (p=0.439), with death in 0.5% and 1.2% (p=0.388). At long-term follow-up (24.4 ± 15.1 months), younger patients showed similar rates of MACE, (12.8% vs. 16.6%, p=0.161), myocardial infarction (3.1% vs. 3.7%, p=0.633), target lesion revascularization (11.3% vs. 12.5%, p=0.627), or stent thrombosis (1.5% vs. 2.8%, p=0.294), despite an increased risk of death in older patients (1.0% vs. 5.0%, p=0.012). Even at extensive multivariable analysis, younger patients still faced a similar risk of MACE (HR=0.78 [0.48-1.27], p=0.318).
  
  
  CONCLUSIONS
  Despite their low age, young patients undergoing PCI for bifurcation face a significant risk of early and late non-fatal adverse events. Thus, they should not be denied careful medical management and follow-up.
authors.affiliation: University of Modena and Reggio Emilia, Modena, Italy. rov_sara@yahoo.it
authors.forename: Sara
authors.initials: S
authors.lastname: Roversi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.forename: Enrico
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Patrizia
authors.initials: P
authors.lastname: Presbitero
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
authors.forename: Leonardo
authors.initials: L
authors.lastname: Paloscia
authors.forename: Paolo
authors.initials: P
authors.lastname: Rubino
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Carlo
authors.initials: C
authors.lastname: Briguori
authors.forename: Luigi
authors.initials: L
authors.lastname: Niccoli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Franco
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Girolamo
authors.forename: Luigi
authors.initials: L
authors.lastname: Piatti
authors.forename: Cesare
authors.initials: C
authors.lastname: Greco
authors.forename: Sonia
authors.initials: S
authors.lastname: Petronio
authors.forename: Bruno
authors.initials: B
authors.lastname: Loi
authors.forename: Ernesto
authors.initials: E
authors.lastname: Lioy
authors.forename: Alberto
authors.initials: A
authors.lastname: Benassi
authors.forename: Aldo
authors.initials: A
authors.lastname: Patti
authors.forename: Achille
authors.initials: A
authors.lastname: Gaspardone
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Modena
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sangiorgi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000639:trends*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome