Introduction: Acute coronary syndromes (ACS) in young patients are uncommon and their influence on morbidity and mortality in this population is still debated. Aim: We investigated clinical and angiographic characteristics, risk factors and outcome in young patients diagnosed with ACS, compared with those of older patients, evaluating survival free from death and/or nonfatal myocardial infarction (MI) and/or coronary revascularization (primary endpoint), and then with respect to each component of the primary endpoint. Methods: We retrospectively analyzed 1696 patients diagnosed with ACS between 2007 and 2013. 116 were aged ≤45 years (young adults), 1116 were >45 and <75 years (older adults) and 464 were ≥75 years. Results: Young adults were mostly male, with a prevalent diagnosis of STEMI, had less frequently typical cardiovascular risk factors and lower prevalence of extensive coronary artery disease. Over a median 3 years follow up, survival free from composite endpoint was better in young than in older adult patients (11.2 vs. 24.2%; p = 0.001), mainly due to a lower rate of death while the occurrence of non fatal MI and of coronary revascularization was similar (7.8 vs. 8.7%, p = 0.86; 8.7 vs. 12.9%, p = 0.23 respectively). Diabetes was the strongest independent risk factor of worse prognosis in the young cohort (OR 3.47; 95% CI 1.01–11.9; p = 0.04). Conclusions: Young adults showed peculiar clinical features and lower mortality compared with older adults. Morbidity was not different between the two populations, with diabetes independently associated with a worse prognosis.

Long-Term Outcome of Acute Coronary Syndromes in Young Patients / Tini, Giacomo; Proietti, Giulia; Casenghi, Matteo; Colopi, Marzia; Bontempi, Katia; Autore, Camillo; Volpe, Massimo; Musumeci, Maria Beatrice. - In: HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION. - ISSN 1120-9879. - 24:1(2017), pp. 77-84. [10.1007/s40292-017-0183-6]

Long-Term Outcome of Acute Coronary Syndromes in Young Patients

Tini, Giacomo;CASENGHI, MATTEO;AUTORE, Camillo;VOLPE, Massimo;MUSUMECI, Maria Beatrice
2017

Abstract

Introduction: Acute coronary syndromes (ACS) in young patients are uncommon and their influence on morbidity and mortality in this population is still debated. Aim: We investigated clinical and angiographic characteristics, risk factors and outcome in young patients diagnosed with ACS, compared with those of older patients, evaluating survival free from death and/or nonfatal myocardial infarction (MI) and/or coronary revascularization (primary endpoint), and then with respect to each component of the primary endpoint. Methods: We retrospectively analyzed 1696 patients diagnosed with ACS between 2007 and 2013. 116 were aged ≤45 years (young adults), 1116 were >45 and <75 years (older adults) and 464 were ≥75 years. Results: Young adults were mostly male, with a prevalent diagnosis of STEMI, had less frequently typical cardiovascular risk factors and lower prevalence of extensive coronary artery disease. Over a median 3 years follow up, survival free from composite endpoint was better in young than in older adult patients (11.2 vs. 24.2%; p = 0.001), mainly due to a lower rate of death while the occurrence of non fatal MI and of coronary revascularization was similar (7.8 vs. 8.7%, p = 0.86; 8.7 vs. 12.9%, p = 0.23 respectively). Diabetes was the strongest independent risk factor of worse prognosis in the young cohort (OR 3.47; 95% CI 1.01–11.9; p = 0.04). Conclusions: Young adults showed peculiar clinical features and lower mortality compared with older adults. Morbidity was not different between the two populations, with diabetes independently associated with a worse prognosis.
2017
acute coronary syndromes; diabetes; myocardial infarction; outcome; young; internal medicine; cardiology and cardiovascular medicine
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Long-Term Outcome of Acute Coronary Syndromes in Young Patients / Tini, Giacomo; Proietti, Giulia; Casenghi, Matteo; Colopi, Marzia; Bontempi, Katia; Autore, Camillo; Volpe, Massimo; Musumeci, Maria Beatrice. - In: HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION. - ISSN 1120-9879. - 24:1(2017), pp. 77-84. [10.1007/s40292-017-0183-6]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/946214
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