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

Benassi, A

Biondi Zoccai, G

Bolognese, L

Briguori, C

Burzotta, F

Capodanno, D

Colombo, A

De Servi, S

Di Girolamo, D

Franco, G

Gaspardone, A

Greco, C

Lioy, E

Loi, B

Modena, M

Niccoli, L

Paloscia, L

Patti, A

Petronio, S

Piatti, L

Presbitero, P

Romagnoli, E

Roversi, S

Rubino, P

Sangiorgi, G

Sardella, G

Sheiban, I

Tamburino, C

GASPARDONE, ACHILLE

SANGIORGI, GIUSEPPE

Sangiorgi, G.

English

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

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 ≤45years, and age >45years. 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 ≤45years group and 2.1% in the >45years group (p=0.439), with death in 0.5% and 1.2% (p=0.388). At long-term follow-up (24.4±15.1months), 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

Roversi S

Biondi Zoccai G

Romagnoli E

Sheiban I

De Servi S

Tamburino C

Colombo A

Burzotta F

Presbiterio P

Bolognese L

Paloscia L

Rubino P

Sardella G

Briguori C

Niccoli L

Franco G

Di Girolamo D

Piatti L

Greco C

Loi B

Lioy E

Benassi A

Patti A

Gaspardone A

Capodanno D

Modena MG

Sangiorgi G.

PETRONIO, ANNA

Archivio della Ricerca - Università di Pisa

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

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 &gt; 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 &gt; 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. © 2012 Elsevier Ireland Ltd

Romagnoli E.

Burzotta F. (ORCID:0000-0002-6569-9401)

Rubino P.

Franco G. (ORCID:0000-0003-3645-7152)

PubliCatt

Presbitero P

Petronio S

DE SERVI, STEFANO

Archivio Istituzionale della Ricerca - Università degli Studi di Pavia

Biondi-Zoccai, G

Archivio della Ricerca - Università di Roma Tor vergata

Cineca Institutional Research Information System

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 ≤45years, and age &gt;45years. 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 ≤45years group and 2.1% in the &gt;45years group (p=0.439), with death in 0.5% and 1.2% (p=0.388). At long-term follow-up (24.4±15.1months), 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

MODENA, Maria Grazia

Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia

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. 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 (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. (C) 2012 Elsevier Ireland Ltd. All rights reserved

Sara Roversi

Enrico Romagnoli

Imad Sheiban

Stefano De Servi

Corrado Tamburino

Antonio Colombo

Francesco Burzotta

Patrizia Presbitero

Leonardo Bolognese

Leonardo Paloscia

Paolo Rubino

Carlo Briguori

Luigi Niccoli

G. Franco

Domenico Di Girolamo

Luigi Piatti

Sonia Petronio

Bruno Loi

Ernesto Lioy

Alberto Benassi

Aldo Patti

Achille Gaspardone

Davide Capodanno

Maria Grazia Modena

Giuseppe Sangiorgi

BIONDI ZOCCAI, GIUSEPPE

SARDELLA, Gennaro

GRECO, Cesare

Archivio della ricerca- Università di Roma La Sapienza

https://art.torvergata.it/retrieve/handle/2108/96717/196222/%23213%20Int%20J%20Cardiol%202012.pdf

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

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