Young coronary artery disease in patients undergoing percutaneous coronary intervention

Abstract

BACKGROUND AND OBJECTIVESUnderstanding the nature and pattern of young coronary artery disease (CAD) is important due to the tremendous impact on these patients’ socio-economic and physical aspect. Data on young CAD in the southeast Asian region is rather patchy and limited. Hence we utilized our National Cardiovascular Disease Database (NCVD)—Percutaneous Coronary Intervention (PCI) Registry to analyze young patients who underwent PCI in the year 2007 to 2009.DESIGN AND SETTINGSThis is a retrospective study of all patients who had undergone coronary angioplasty from 2007 to 2009 in 11 hospitals across Malaysia.METHODSData were obtained from the NCVD—PCI Registry, 2007 to 2009. Patients were categorized into 2 groups—young and old, where young was defined as less than 45 years for men and less than 55 years for women and old was defined as more than or equals to 45 years for men and more than or equals to 55 years for women. Patients’ baseline characteristics, risk factor profile, extent of coronary disease and outcome on discharge, and 30-day and 1-year follow-up were compared between the 2 groups.RESULTSWe analyzed 10 268 patients, and the prevalence of young CAD was 16% (1595 patients). There was a significantly low prevalence of Chinese patients compared to other major ethnic groups. Active smoking (30.2% vs 17.7%) and obesity (20.9% vs 17.3%) were the 2 risk factors more associated with young CAD. There is a preponderance toward single vessel disease in the young CAD group, and they had a favorable clinical outcome in terms of all-cause mortality at discharge (RR 0.49 [CI 0.26–0.94]) and 1-year follow-up (RR 0.47 [CI 0.19–1.15]).CONCLUSIONWe observed distinctive features of young CAD that would serve as a framework in the primary and secondary prevention of the early onset CAD.

Acute coronary syndrome in the elderly: the Malaysian National Cardiovascular Disease Database- Acute Coronary Syndrome registry

“…This finding is consistent with previous reports from the Southeast Asian region, which linked discrepancies in the age of onset for coronary artery disease with differences in ethnicity. (11)(12)(13) In most of our institutions, pharmacological treatment for patients with ACS is still relevant, especially in the acute treatment of STEMI (e.g. intravenous thrombolysis).…”

Intervenção Coronária Percutânea em Pacientes Jovens

“…The frequency of younger patients (under 40 years) in PCI registries has ranged from 1% to 16%. [10][11][12] The increasingly earlier exposure to smoking, obesity, and stress have been listed as a cause of CVD in young people. [12][13][14] In the present study, smoking was the most common risk factor among young people, who were mostly males.…”

Comparison of Short-term Outcomes of Percutaneous Coronary Intervention between Young Male and Female Patients with Acute Coronary Syndrome

“…6 There is disparity in the literature on the definition of "young" with respect to premature CAD and ACS, with the age cut-off varying from ≤40 to ≤55 years in various studies. [7][8][9] Cardiovascular disease develops 7 to 10 years later in women than in men, 10 leading to a difference in the definition of the "young" ACS patient for each gender,arising from the fundamental differences in the physiology of women and a protective effect of endogenous oestrogens against CAD. As such, "young" patients in relation to ACS have been defined in the literature as females <55 years of age, and males <45 years of age, a similar cut-off that has been adopted in this study.…”