Prognostic Factors and Outcomes in Young Chinese Patients With Acute Myocardial Infarction Undergoing Primary Coronary Angioplasty

Abstract

SummaryWe investigated the prognostic risk and the clinical outcome of young-adult patients with ST-segment elevation (ST-se) acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). Between May 999 and September 2007, primary PCI was performed in 680 consecutive patients with AMI of onset < 2 hours (cardiogenic shock within 8 hours) at Kaohsiung Chang Gung Memorial Hospital. Of these patients, 63 (9.7%) young-age patients (defined as male of < 45 years old and female of < 55 years old) were enrolled into this study. A comparable number (n = 75) of patients ≥ 55 years old, who presented with AMI of < 2 hours duration having undergone primary PCI between November 2004 and May 2006, were retrospectively reviewed and enrolled as control subjects. The procedural success (defined as normal blood flow achieved in the infract-related artery) was similar between the young-age and old-age patients (P = .0). Additionally, the incidence of an advanced Killip score (defined as ≥ score 3 upon presentation), 30-day and 6-month cumulative mortality did not differ between these two groups of patients (P > 0.). However, the 30-day major adverse clinical outcome (MACO) (defined as New York Heart Association Functional Classification ≥ 3 or 30-day mortality) was significantly lower in the young-age than in the old-age patients (P < 0.00). Further, multiple stepwise logistic regression analysis showed that an advanced Killip score along with the peak level of CK-MB was independently predictive of 30-day MACO (P < 0.05) in young-age patients. In conclusion, the prognostic outcome is favorable in young-adult ST-se AMI undergoing primary PCI. Traditional risk factors remain effective for stratification of young-adult AMI patients into high-or low-risk subgroups. (Int Heart J 2009; 50: -)

A Risk-Adjusted Retrospective Data Analysis between Younger and Elderly Patients with Acute Coronary Syndromes—Long-Term Prognosis

“…Other study described a mortality of 4.9% in 30-day period in young patients compared to 8.6% in the rest of population. After six months, the mortality was 5.5% in young patients and 9.7% in the elderly group [11]. With mean 4-year follow-up, the only prolonged monitoring study with young patients diagnosed with ACS showed 28% of need for reintervention in coronary artery disease who had expressed acute myocardial infarction [1].…”

Acute coronary syndrome in the young Nepalese population with their angiographic characteristics

“…1 On currently available evidence, young patients represent 0.4% to 19% of all acute coronary syndrome (ACS) cases, depending on the cut-off age used. [2][3][4] As classic coronary atherosclerotic plaque rupture is considered to be rare during the early decades of life, uncommon etiologies may be considered. The cardiovascular risk factors, the extent of coronary artery disease and clinical outcome after ACS might be different from those of older patients.…”

One year prognosis of young Middle Eastern patients undergoing percutaneous coronary interventions

“…Although 45 years of age or younger is the age used more often than others; studies defined age as <35 years, <40 years, <44, <46 years, <50, and <55 years. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Young patients, in general, account for <12% of CAD or ACS patients. 21,27 Studies reported percentages as low as 2.6% and 5.8%, and as high as 8% and 11.6%; less than the 13% reported in this study.…”

“…7,21,22,28,37,38 Most of published studies of outcome in young patients limited their data to the in-hospital adverse events with a mortality rate that ranged between 1.6% and 3%. 11,17 These rates were not necessarily lower than those observed among older patients, as demonstrated by the current study, where the in-hospital mortality rates in the young and older patients were not different (0.97% and 0.85%; respectively).…”