Comparison of immediate results and follow-up of patients with single-vessel and multivessel coronary artery disease younger than 50 years of age undergoing coronary stent implantation

Abstract

The prevalence of coronary artery disease, especially in its multivessel form, in the population aged less than 50 years has increased. This fact may be partially explained by the current lifestyle favoring sedentary habits, stress, obesity, smoking, and the greater incidence of type II diabetes mellitus, well-known factors of coronary risk [1][2][3] . Before the appearance of stents, the use of coronary angioplasty in the treatment of patients with multivessel disease was limited by the impossibility of approaching more complex lesions and the elevated rate of restenosis [4][5][6] . With the increased use of devices in the treatment of coronary artery disease, several studies have assessed their use in select or unselect groups of patients with multivessel disease 7,8 ; however, the reports on the benefits of these devices in younger patients are scarce.The objective of this study was to assess the in-hospital results and the clinical follow-up of patients with multivessel disease aged less than 50 years undergoing coronary stent implantation in native coronary arteries and to compare them with those of patients with single-vessel disease. MethodsThis study comprised a consecutive series of 462 patients aged less than 50 years, undergoing percutaneous coronary intervention with coronary stent implantation from July 1997 to June 2002 at the Hospital da Beneficiência Portuguesa of São Paulo.The study sample comprised patients with "de novo" lesions in the native coronary artery with clinical findings of stable or unstable angina or documented myocardial ischemia. Patients undergoing angioplasty in the acute phase of myocardial infarction, adjunct procedures of atheroablation, and those with contraindications for antithrombotic or platelet antiaggregating therapy were excluded.The patients were divided into the following 2 groups Objective -To assess the in-hospital results and clinical follow-up of young patients (< 50 years) with multivessel coronary artery disease undergoing stent implantation in native coronary arteries and to compare their results with those of patients with single-vessel coronary artery disease. Methods -We retrospectively studied 462 patients undergoing coronary stent implantation. Patients were divided into 2 groups: group I (G-I) -388 (84%) patients with single-vessel coronary artery disease; and group II (G-II) -74 (16%) patients with multivessel coronary artery disease.Results -The mean age of the patients was 45+4.9 years, and the clinical findings at presentation and demographic data were similar in both groups. The rate of , with no difference in regard to in-hospital evolution between the groups. Death, acute myocardial infarction, and the need for myocardial revascularization during clinical follow-up occurred in 10. respectively. By the end of 24 months, the actuarial analysis showed an event-free survival of . Conclusion -

Impact of multivessel coronary artery disease on early and late clinical outcome in ST-Segment elevation myocardial infarction patients who underwent percutaneous coronary intervention: insight from Indonesia

“…Furthermore, it was concluded from that the MVD has similarity in major adverse cardiovascular events compared with the SVD after underwent PCI procedure. 13 In this study, the echocardiographic results including EF, TAPSE, LVIDd, LAVI, GLS, ∆EF, ∆TAPSE, and ∆GLS were not significantly different between the MVD case group compared with the SVD case group after 30-d and 90-d follow-up (TABLE 5). Although the MVD case group had higher in EF and TAPSE as well as lower in LVIDd and LAVI, however they were not significantly different (p>0.05).…”

“…No significant difference in major adverse cardiovascular events after 90-d follow up was observed. Anello et al 13 also reported that there is no significant difference in major adverse cardiovascular events among Brazilian patients with single vessel and multiple vessel coronary artery disease younger than 50 y.o. undergoing coronary stent implantation.…”