Clinical Characteristics and Outcomes of Chinese Patients with Premature Acute Coronary Syndrome

Abstract

This study aimed to investigate the clinical characteristics and major adverse cardiovascular events (MACEs) of Chinese patients with premature acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This study was a secondary retrospective analysis involving 2114 ACS patients undergoing PCI at a single center in China. The patients were divided into two groups according to age (premature ACS group: !55 years in men, !65 years in women; nonpremature ACS group: > 55 years in men, > 65 years in women). The primary endpoint was all-cause death, and the secondary endpoint was a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, target vessel revascularization, and recurrent angina at follow-up, defined as MACEs. The incidence of all-cause death and MACEs was significantly lower in the premature than in the nonpremature ACS group (P < 0.001). Female sex, higher triglyceride levels, and higher low-density lipoprotein cholesterol levels were identified as independent risk factors that accelerated the development of ACS, whereas higher high-density lipoprotein cholesterol levels were identified as protective factors. Furthermore, in patients with premature ACS, non-ST-elevation ACS, cardiac insufficiency, multivessel disease, and left main lesion were risk factors for MACEs. Younger individuals, especially females, are advised to undergo early screening for the risk factors of premature ACS. Primary prevention of dyslipidemia should be more aggressively promoted at a young age. For premature ACS patients undergoing PCI, strengthened management and regular re-examinations are necessary to avoid adverse cardiovascular events as much as possible.

Risk assessment for mortality in patients with ST‐elevation myocardial infarction undergoing primary percutaneous coronary intervention: A retrospective cohort study

“…These data are consistent with our results. However, numerous studies suggested that women are more likely than men to develop side effects after PCI, regardless of age, and young women have a higher mortality risk after an elective PCI 22–24 . Although sex differences were significant in univariate analysis, it was not an independent risk predictor for long‐term mortality.…”

The Association of Desert Dust with the Risk of Acute Coronary Syndrome in Subjects of a Younger Age

“…These time intervals were chosen because all the required atmospheric data were available and collected on a retrospective basis. We defined premature ACS as coronary disease diagnosed before 55 years of age [5]. Patients with one of two forms of ACS, either ST-elevation myocardial infarction (STEMI) or non-ST-elevation ACS (NSTE-ACS), were included in this study.…”

“…Based on the age at disease onset, ACS is considered premature when it develops in young individuals (<55 years of age), similar to the definition of premature coronary artery disease [5]. The manifestation of ACS in young subjects is associated with an important decrease in life expectancy [5].…”

Acute kidney injury prediction model utility in premature myocardial infarction

“…Many previous studies had also adopted the same age criteria. 11 , 12 RIFLE (risk, injury, failure, loss, end stage renal disease), AKIN (acute kidney injury network), and KDIGO (kidney disease: improving global outcomes) are considered favorable tools for diagnosing AKI. However, the KDIGO criteria have been recognized to better correlate disease severity with cardiovascular and other complications.…”