J Transcat Intervent.2019;27:eA201819.
Temporal trends and outcomes of percutaneous coronary intervention in young patients (aged ≤40 years)
The prevalence of coronary artery disease and percutaneous coronary intervention in young patients is not well established. The objective of this study was to investigate the profile of young patients undergoing percutaneous coronary intervention in Brazil.
A cross-sectional study was performed with data from the Central Nacional de Intervenções Cardiovasculares (CENIC), collected between 2006 and 2016, for patients aged ≤40 years undergoing percutaneous coronary intervention.
We enrolled 2,806 patients, mean age of 35.3±3.9 years. Most lesions on angiography were single-vessel (66.6%), in the left anterior descending artery (50.8%), and complex (68%). In respect to procedures, there was a difference over the years in the use of drug-eluting stents (p<0.0001), vessel diameter (p=0.015), stent length (p<0.0001), type of intervention (p=0.036), use of glycoprotein IIb/IIIa inhibitors (p<0.0001), thromboaspiration (p=0.0003), post-procedural TIMI flow (p=0.007), and post-procedural stenosis (p<0.001). As for in-hospital clinical outcomes, there were no significant differences among the periods. In the multivariate analysis, female sex (OR: 3.45; 95%CI: 1.25-9.5; p=0.016), hypertension (OR: 4.84; 95%CI: 1.34-17.52; p=0.016), previous coronary artery bypass graft (OR: 16.42; 95%CI: 1.62-166.45; p=0.018), primary percutaneous coronary intervention (OR: 25.67; 95%CI: 5.19-126.99; p=0.0001) and rescue percutaneous coronary intervention (OR: 26.44; 95%CI: 2.11-330.82; p=0.011) were independent predictors of in-hospital mortality.
Percutaneous coronary intervention in young patients, in the CENIC registry, shows cases of high angiographic complexity, high success rates and low in-hospital complication rates over a 10-year period.