Comparison of Outcomes of Coronary Artery Disease Treated by Percutaneous Coronary Intervention in 3 Different Age Groups (<45, 46-65, and >65 Years)

Am J Cardiol. 2021 Aug 1:152:19-26. doi: 10.1016/j.amjcard.2021.05.002. Epub 2021 Jun 17.

Abstract

There is paucity of data examining long-term outcomes of premature coronary artery disease (CAD). We aimed to investigate the short- and long-term clinical outcomes of patients with premature CAD treated by percutaneous coronary intervention (PCI) compared to older cohorts. We analyzed data from 27,869 patients who underwent PCI from 2005-2017 enrolled in a multicenter PCI registry. Patients were divided into three age groups: young group (≤ 45 years), middle-age group (46-65 years) and older group (>65 years). There were higher rates of current smokers in the young (n = 1,711) compared to the middle-age (n = 12,830) and older groups (n = 13,328) (54.2% vs 34.6% vs 11%) and the young presented more frequently with acute coronary syndrome (ACS) (78% vs 66% vs 62%), all p <0.05. There were also greater rates of cardiogenic shock (CS), out-of-hospital cardiac arrest (OHCA) and ST-elevation myocardial infarction (STEMI) in the young, all p <0.05. The young cohort with STEMI had higher rates of in-hospital, 30-day death, and long-term mortality (3.8% vs 0.2%, 4.3% vs 0.2% and 8.6% vs 3.1%, all p <0.05, respectively) compared to the non-STEMI subgroup. There was a stepwise increase in long-term mortality from the young, to middle-age, to the older group (6.1% vs 9.9% vs 26.8%, p <0.001). Younger age was an independent predictor of lower long-term mortality (HR 0.66, 95% CI 0.52-0.84, p = 0.001). In conclusion, younger patients presenting with STEMI had worse prognosis compared to those presenting with non-STEMI. Despite higher risk presentations among young patients, their overall prognosis was favorable compared to older age groups.

Publication types

  • Comparative Study

MeSH terms

  • Acute Coronary Syndrome / epidemiology
  • Acute Coronary Syndrome / physiopathology
  • Acute Coronary Syndrome / surgery*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery*
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Myocardial Infarction / epidemiology
  • Out-of-Hospital Cardiac Arrest / epidemiology
  • Percutaneous Coronary Intervention*
  • ST Elevation Myocardial Infarction / complications
  • ST Elevation Myocardial Infarction / epidemiology
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / surgery*
  • Shock, Cardiogenic / epidemiology
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / physiopathology
  • Stroke / epidemiology
  • Stroke Volume