Short-term Outcomes and Mid-term Follow-up After Coronary Angioplasty in Patients Younger Than 40 Years of Age

Abstract

Background: Stenting is currently the standard of care in percutaneous coronary intervention (PCI). Whether young patients remain at increased risk after PCI in the present stent era has not been investigated widely. We evaluated angiographic characteristics and short- and mid-term outcomes in patients younger than 40 years of age who underwent PCI.

Methods: From April 2003 to March 2005, prospective data were collected in 118 consecutive patients, who were less than 40 years of age and underwent PCI at our referral center. The PCI outcomes in these patients were compared to those in 354 patients, randomly selected from 2493 patients older than 40 years of age in our database. Follow-up was scheduled at 1 month, 5 months, and 9 months through clinic visits, telephone interviews, and reviewing hospital records.

Results: Patients<40 years of age were more often male (91.5% vs. 71.8%, P<0.001), current smokers (33.9% vs. 15.2 %, P<0.001), and had more family history of coronary artery disease (38.1% vs. 21.8%, P<0.001) and myocardial infarction (44.1 vs. 31.1, p=0.01), while diabetes mellitus (6.8% vs. 22.1%, P<0.001), hypertension (13.6% vs. 35.3%, P<0.001), and hyperlipidemia (34.7% vs. 44.8%, P=0.055) were less common in these patients. There were no significant differences between the two groups regarding vessel involvement, reference vessel diameter, stenosis rate (before and after procedure), and lesion characteristics, with an exception that angulated lesions were more common in the patients≤ 40 years of age (P<0.05). The young patients, who underwent PCI, presented more frequently with single-vessel disease (61% vs. 46%, P=0.01).The vessel and lesion sites of PCI and clinical success rates were similar in these age groups. Usage of stent was high and similar, and drug- eluting stent use was not significantly different between the two groups. With a high procedural success (94.9% vs. 91.8%), intra-hospital and late complications were very low and similar in both groups.

Conclusion: Percutaneous coronary intervention is a safe and effective procedure for young patients, and major adverse cardiac events are similar in young and older patients.