Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Francesco Burzotta, Franco Glieca, Elisa Romagnoli, Pasquale Rubino, Sara Roversi, Imad Sheiban, Corrado Tamburino, Antonio Colombo, Patrizia Presbitero, Leonardo Bolognese, Leonardo Paloscia, Paolo Rubino, Gennaro Sardella, Carlo Briguori, Luigi Niccoli, Gianfranco Franco, Domenico Di Girolamo, Luigi Piatti, Cesare Greco, Sonia PetronioBruno Loi, Alberto Benassi, Aldo Patti, Achille Gaspardone, Davide Capodanno, Maria Grazia Modena

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)

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. © 2012 Elsevier Ireland Ltd.
Lingua originaleEnglish
pagine (da-a)2995-2999
Numero di pagine5
RivistaINTERNATIONAL JOURNAL OF CARDIOLOGY
Volume167
DOI
Stato di pubblicazionePubblicato - 2013

Keywords

  • Adult
  • Age
  • Age Factors
  • Aged
  • Bifurcation
  • Coronary Artery Disease
  • Coronary artery disease
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention
  • Percutaneous transluminal coronary angioplasty
  • Retrospective Studies
  • Stent
  • Time Factors
  • Treatment Outcome

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