Long-term prognosis and clinical characteristics of young adults (≤40 years old) who underwent percutaneous coronary intervention.
BACKGROUND
Limited data exist regarding the long-term prognosis of percutaneous coronary intervention (PCI) in young adults. The aim of this study was to retrospectively assess the long-term clinical outcomes in young patients who underwent PCI.


RESULTS
Between 1985 and 2011, 7649 consecutive patients underwent PCI, and data from 69 young adults (age ≤40 years) and 4255 old adults (age ≧65 years) were analyzed. A Cox proportional hazards regression analysis was used to determine the independent predictors of a composite endpoint that included all-cause death and acute coronary syndrome (ACS) during the follow-up period. The mean age of the 69 young patients was 36.1±4.9 years, and 96% of them were men. Approximately 30% were current smokers, and their body mass index (BMI) was 26.7±5.0kg/m(2). The prevalence of diabetes and hypertension was 33% and 48%, respectively. All patients had ≥1 conventional cardiovascular risk factor. At a median follow-up of 9.8 years, the overall death rate was 5.8%, and new-onset ACS occurred in 8.7%. Current smoking was an independent predictor of the composite endpoint (hazard ratio 4.46, confidence interval 1.08-19.1, p=0.04) for young adults.


CONCLUSIONS
Current smoking and obesity (high BMI) are the important clinical characteristics in young Japanese coronary heart disease patients who undergo PCI. The long-term prognosis in young patients is acceptable, but current smoking is a significant independent predictor of death and the recurrence of ACS in young Japanese coronary heart disease patients who are obese.
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Hirokazu
H
Konishi
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: ktmmy@med.juntendo.ac.jp.
Katsumi
K
Miyauchi
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Takatoshi
T
Kasai
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Shuta
S
Tsuboi
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Manabu
M
Ogita
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Ryo
R
Naito
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Yoshiteru
Y
Katoh
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Iwao
I
Okai
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Hiroshi
H
Tamura
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Shinya
S
Okazaki
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Hiroyuki
H
Daida
D054058:Acute Coronary Syndrome; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
Long-term prognosis; Percutaneous coronary intervention; Smoking; Young adult