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. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients / Sara, Roversi; BIONDI ZOCCAI, Giuseppe; Enrico, Romagnoli; Imad, Sheiban; Stefano De, Servi; Corrado, Tamburino; Antonio, Colombo; Francesco, Burzotta; Patrizia, Presbitero; Leonardo, Bolognese; Leonardo, Paloscia; Paolo, Rubino; Sardella, Gennaro; Carlo, Briguori; Luigi, Niccoli; G., Franco; Domenico Di, Girolamo; Luigi, Piatti; Greco, Cesare; Sonia, Petronio; Bruno, Loi; Ernesto, Lioy; Alberto, Benassi; Aldo, Patti; Achille, Gaspardone; Davide, Capodanno; Maria Grazia, Modena; Giuseppe, Sangiorgi. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - STAMPA. - 167:6(2013), pp. 2995-2999. [10.1016/j.ijcard.2012.09.005]

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

BIONDI ZOCCAI, GIUSEPPE;SARDELLA, Gennaro;GRECO, Cesare;
2013

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. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
2013
coronary artery disease; age; stent; percutaneous transluminal coronary angioplasty; bifurcation
01 Pubblicazione su rivista::01a Articolo in rivista
Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients / Sara, Roversi; BIONDI ZOCCAI, Giuseppe; Enrico, Romagnoli; Imad, Sheiban; Stefano De, Servi; Corrado, Tamburino; Antonio, Colombo; Francesco, Burzotta; Patrizia, Presbitero; Leonardo, Bolognese; Leonardo, Paloscia; Paolo, Rubino; Sardella, Gennaro; Carlo, Briguori; Luigi, Niccoli; G., Franco; Domenico Di, Girolamo; Luigi, Piatti; Greco, Cesare; Sonia, Petronio; Bruno, Loi; Ernesto, Lioy; Alberto, Benassi; Aldo, Patti; Achille, Gaspardone; Davide, Capodanno; Maria Grazia, Modena; Giuseppe, Sangiorgi. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - STAMPA. - 167:6(2013), pp. 2995-2999. [10.1016/j.ijcard.2012.09.005]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/482472
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