Risk Factor Distribution and Long-Term Outcomes in Young Patients Undergoing Percutaneous Coronary Intervention in Macedonia

Abstract

The aim was to assess coronary artery disease (CAD) risk factor distribution and long-term outcomes in young patients undergoing percutaneous coronary intervention (PCI) in Macedonia. A total of 12,361 PCI patients (from March 2011 to December 2017) were included in the study. Group 1 included 309 young patients aged ≤40 as the main study group, comparing them to 12,052 older PCI patients (group 2) during the study period. We compared CAD risk factor distribution, clinical and procedure characteristics. Additionally, angiographic data, long-term major adverse cardiac and cerebrovascular events (MACCE) and mortality were analyzed in group 1 patients. Median age was 36±4 years in group 1 and 62±11 years in group 2. Male patients predominated in both groups (88% vs.73%). Positive family history for CAD, smoking and obesity was much more common in the young group (p<0.0001). ST segment elevation myocardial infarction (STEMI) primary PCI was also more frequent with 48% of PCI in the young group (p<0.0001). Multivessel CAD and chronic total occlusion interventions were more common in the older group (51% and 28%, respectively; p<0.0001). Procedure duration (31±0.4 vs. 35±22 min) and fluoroscopy time (9±4 vs. 9±12 min) were similar in both groups. There was no difference in access site bleeding (4.8% vs. 4.3%). During the 3.5-year median follow up, MACCE was present in 1.9% of young patients. In conclusion, positive family history for CAD, obesity and smoking were the most common risk factors in the young PCI population. Young PCI patients usually had single vessel CAD with STEMI being more frequent as the cause for primary PCI. Long-term annual survival exceeded 99% in these patients with excellent prognosis after PCI.

Peripheral vascular disease hospitalizations with cardiovascular disease risk and major adverse cardiac and cerebrovascular events occur at increasingly younger age across two nationwide cohorts selected 10-years apart

“…These risk factors’ increased prevalence in young compared to the older population has already been described by Zafirovska et al, which may be linked to reported PCI requirements in such patients. 7 Comparably, we have also observed decreased age at presentation in patients who required PCI in our study. Interventional procedures required in PVD patients with multiple comorbid risk factors at a younger age may affect healthcare costs adversely.…”

The Effect of Sleep Quality on Coronary Lesion Severity and Prognosis in the Young Acute Coronary Syndrome Population

“…In recent years, the incidence of ACS among the young population (under the age of 45) has significantly increased [1,31]. Compared with those in the elderly, the risk factors of ACS in young people have different characteristics, which are closely related to abnormal living habits such as smoking, less physical activity, excessive stress, and sleep disorders [32,33]. As our literature review illustrated, short sleep duration, shift work, and poor sleep quality could all promote adverse health, including headache, stroke, gastrointestinal disorders, and cardiovascular disease [34][35][36][37].…”

Correlates of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Kosovo

“…Different studies [24][25][26] found important variations among STEMI, NSTEMI and UA patients in the incidence of heart failure and mortality. In other conditions, the in-hospital mortality rate was also higher before PCI [27][28][29][30][31][32][33][34] .…”