Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Sara Roversi, Giuseppe Biondi-Zoccai, Enrico Romagnoli, Imad Sheiban, Stefano De Servi, Corrado Tamburino, Antonio Colombo, Francesco Burzotta, Patrizia Presbitero, Leonardo Bolognese, Leonardo Paloscia, Paolo Rubino, Gennaro Sardella, Carlo Briguori, Luigi Niccoli, Gianfranco Franco, Domenico Di Girolamo, Luigi Piatti, Cesare Greco, Sonia PetronioBruno Loi, Ernesto Lioy, Alberto Benassi, Aldo Patti, Achille Gaspardone, Davide Capodanno, Maria Grazia Modena, Giuseppe Sangiorgi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Coronary artery disease is most common in older patients, but may occur in younger subjects. The outlook of young patients after percutaneous coronary intervention (PCI) of challenging lesion subsets such as coronary bifurcations, is not established. We thus aimed to appraise the early and long-term results of PCI for bifurcations in young patients. Methods: A multicenter, retrospective study was conducted enrolling consecutive patients undergoing bifurcation PCI between 2002 and 2006 in 22 Italian centers. Patients were divided in 2 groups: age ≤ 45 years, and age > 45 years. The primary end-point was long-term rate of major adverse cardiac events (MACE). Results: 4,314 patients were included: 195 (4.5%) in the younger group, and 4119 (95.5%) in the older group. 30-day outcomes did not show significant differences in MACE rates, with 1.0% in the ≤ 45 years group and 2.1% in the > 45 years group (p = 0.439), with death in 0.5% and 1.2% (p = 0.388). At long-term follow-up (24.4 ± 15.1 months), younger patients showed similar rates of MACE, (12.8% vs. 16.6%, p = 0.161), myocardial infarction (3.1% vs. 3.7%, p = 0.633), target lesion revascularization (11.3% vs. 12.5%, p = 0.627), or stent thrombosis (1.5% vs. 2.8%, p = 0.294), despite an increased risk of death in older patients (1.0% vs. 5.0%, p = 0.012). Even at extensive multivariable analysis, younger patients still faced a similar risk of MACE (HR = 0.78 [0.48-1.27], p = 0.318). Conclusions: Despite their low age, young patients undergoing PCI for bifurcation face a significant risk of early and late non-fatal adverse events. Thus, they should not be denied careful medical management and follow-up.

Original languageEnglish
Pages (from-to)2995-2999
Number of pages5
JournalInternational Journal of Cardiology
Volume167
Issue number6
DOIs
Publication statusPublished - 2013

Keywords

  • Age
  • Bifurcation
  • Coronary artery disease
  • Percutaneous transluminal coronary angioplasty
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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