Ivan Petry Feijó, Márcia Moura Schmidt, Renato Budzyn David, João Maximiliano Pedron Martins, Karine Elisa Schmidt, Carlos Antonio Mascia Gottschall, Alexandre Schaan de Quadros
{"title":"Clinical profile and outcomes of primary percutaneous coronary intervention in young patients","authors":"Ivan Petry Feijó, Márcia Moura Schmidt, Renato Budzyn David, João Maximiliano Pedron Martins, Karine Elisa Schmidt, Carlos Antonio Mascia Gottschall, Alexandre Schaan de Quadros","doi":"10.1016/j.rbciev.2015.01.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The epidemiology of acute myocardial infarction with ST-segment elevation (STEMI) has been modified in recent years, focusing on young people. Our goal was compare the clinical profile, laboratory, angiographic, and 30-day clinical outcomes of patients ≤ 40 years with those > 40 years undergoing primary percutaneous coronary intervention (pPCI).</p></div><div><h3>Methods</h3><p>Prospective cohort study of consecutive patients undergoing pPCI between 2009 and 2011.</p></div><div><h3>Results</h3><p>A total of 1,055 patients were included, 3.3% of them ≤ 40 years. Young patients were more often black, smokers and with a family history of coronary artery disease, and less often hypertensive and dyslipidemic. In patients ≤ 40 years, leukocyte count and ultrasensitive troponin levels at admission were higher, and high density lipoprotein-cholesterol, lower. The left anterior descending artery as a culprit vessel and left ventricular ejection fraction did not differ between groups. Although the TIMI 3 flow pre-intervention was similar, young people showed higher prevalence of myocardial blush 3 pre-procedure. The door-to-balloon time was lower in younger patients (1.0 hour [0.8-1.4 hour] vs. 1.3 hour [0.9-1.7 hour]; <em>p</em> = 0.03). At 30 days, patients ≤ 40 years had a mortality of 0% vs. 8.8% for patients > 40 years (<em>p</em> = 0.07).</p></div><div><h3>Conclusions</h3><p>Patients ≤ 40 years with STEMI and undergoing pPCI show differences in clinical, angiographic and procedural characteristics compared to those > 40 years. In this analysis, representative of the current medical practice, the 30-day mortality of these patients was very low.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 1","pages":"Pages 48-51"},"PeriodicalIF":0.0000,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.01.007","citationCount":"8","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Brasileira de Cardiologia Invasiva (English Edition)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214123515000113","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 8
Abstract
Background
The epidemiology of acute myocardial infarction with ST-segment elevation (STEMI) has been modified in recent years, focusing on young people. Our goal was compare the clinical profile, laboratory, angiographic, and 30-day clinical outcomes of patients ≤ 40 years with those > 40 years undergoing primary percutaneous coronary intervention (pPCI).
Methods
Prospective cohort study of consecutive patients undergoing pPCI between 2009 and 2011.
Results
A total of 1,055 patients were included, 3.3% of them ≤ 40 years. Young patients were more often black, smokers and with a family history of coronary artery disease, and less often hypertensive and dyslipidemic. In patients ≤ 40 years, leukocyte count and ultrasensitive troponin levels at admission were higher, and high density lipoprotein-cholesterol, lower. The left anterior descending artery as a culprit vessel and left ventricular ejection fraction did not differ between groups. Although the TIMI 3 flow pre-intervention was similar, young people showed higher prevalence of myocardial blush 3 pre-procedure. The door-to-balloon time was lower in younger patients (1.0 hour [0.8-1.4 hour] vs. 1.3 hour [0.9-1.7 hour]; p = 0.03). At 30 days, patients ≤ 40 years had a mortality of 0% vs. 8.8% for patients > 40 years (p = 0.07).
Conclusions
Patients ≤ 40 years with STEMI and undergoing pPCI show differences in clinical, angiographic and procedural characteristics compared to those > 40 years. In this analysis, representative of the current medical practice, the 30-day mortality of these patients was very low.