Document Detail


Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients.
MedLine Citation:
PMID:  22995415     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 ≤45years, and age >45years. 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 ≤45years group and 2.1% in the >45years group (p=0.439), with death in 0.5% and 1.2% (p=0.388). At long-term follow-up (24.4±15.1months), 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:
Sara Roversi; Giuseppe Biondi-Zoccai; Enrico Romagnoli; Imad Sheiban; Stefano De Servi; Corrado Tamburino; Antonio Colombo; Francesco Burzotta; Patrizia Presbitero; Leonardo Bolognese; Leonardo Paloscia; Paolo Rubino; Gennaro Sardella; Carlo Briguori; Luigi Niccoli; Gianfranco Franco; Domenico Di Girolamo; Luigi Piatti; Cesare Greco; Sonia Petronio; Bruno Loi; Ernesto Lioy; Alberto Benassi; Aldo Patti; Achille Gaspardone; Davide Capodanno; Maria Grazia Modena; Giuseppe Sangiorgi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-17
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Cardiology, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: rov_sara@yahoo.it.
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