Premature coronary artery disease in all-comers undergoing first PCI Article Swipe
Tineke H. Pinxterhuis
,
Eline H. Ploumen
,
Paolo Zocca
,
Carl E. Schotborgh
,
Rutger L. Anthonio
,
Ariel Roguin
,
Peter W. Danse
,
Edouard Benit
,
Adel Aminian
,
Clemens von Birgelen
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/eurheartj/ehad655.1342
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/eurheartj/ehad655.1342
Background The prevalence of coronary artery disease (CAD) increases with age, yet some individuals develop obstructive CAD at younger age. Purpose The present analysis aimed to assess differences in baseline risk profile and 3-year adverse event risk between patients undergoing percutaneous coronary intervention (PCI) for premature or non-premature CAD. Methods We pooled patient-level data of four randomized PCI trials in all-comers (TWENTE (clinicaltrials.gov: NCT01066650); DUTCH PEERS (NCT01331707); BIO-RESORT (NCT01674803); and BIONYX (NCT02508714)), who had no previous coronary revascularization (by PCI or coronary artery bypass surgery) or myocardial infarction (MI). Premature CAD was defined as CAD in men <50 years and in women <55 years, while non-premature CAD was classified as CAD in older patients. Main clinical endpoint was major adverse cardiac events (MACE), a composite of all-cause mortality, any MI, emergent coronary bypass surgery, or clinically indicated target lesion revascularization. Results Of all 6,171 PCI patients with first revascularizations, one out of seven (n=887, 14.4%) had premature CAD. These patients had lower rates of diabetes (10.6% vs. 16.6%, p<0.001), hypertension (32.7% vs. 50.7%, p<0.001), hypercholesterolemia (35.9% vs. 40.3%, p=0.012), and peripheral arterial disease (2.0% vs. 6.6%, p<0.001). Yet, they were more often overweight (76.2% vs. 69.8%, p<0.001), smoker (60.7% vs. 26.4%, p<0.001), and had more often a family history of CAD (59.8% vs. 44.5%, p<0.001). Patients with premature CAD suffered more often from acute ST-segment elevation MI and underwent less often treatment of calcified or bifurcated lesions (Table 1). At 3-year follow-up, the main endpoint MACE did not differ significantly between patients with premature and non-premature CAD (6.6% vs. 9.4%; adj.HR:0.86, 95%-CI:0.65-1.16, p=0.33; Figure 1). All-cause mortality was lower in patients with premature CAD (0.8% vs. 4.4%; adj.HR:0.23, 95%-CI:0.10-0.52, p<0.001). Yet, in patients with premature CAD the rate of repeated target vessel revascularization was higher than in patients with non-premature CAD (6.1% vs. 4.3%; adj.HR: 1.63, 95%-CI:1.18-2.26, p=0.003). In addition, their definite stent thrombosis risk was higher (1.0% vs. 0.5%; adj.HR:3.20, 95%-CI:1.39-7.38; p=0.006) than in patients with non-premature CAD. Conclusions One out of seven patients who were treated with PCI had premature CAD, and these patients had less complex risk profiles. Patients with premature CAD had higher risks for repeated revascularization and stent thrombosis, but the 3-year all-cause mortality risk was lower. In patients with premature CAD, long-term outcome after PCI might be improved by addressing modifiable risk factors such as smoking and overweight.Figure 1:Kaplan-Meier cumulative event
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/eurheartj/ehad655.1342
- https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.1342/53594359/ehad655.1342.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388601159
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388601159Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/eurheartj/ehad655.1342Digital Object Identifier
- Title
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Premature coronary artery disease in all-comers undergoing first PCIWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
-
2023-11-01Full publication date if available
- Authors
-
Tineke H. Pinxterhuis, Eline H. Ploumen, Paolo Zocca, Carl E. Schotborgh, Rutger L. Anthonio, Ariel Roguin, Peter W. Danse, Edouard Benit, Adel Aminian, Clemens von BirgelenList of authors in order
- Landing page
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https://doi.org/10.1093/eurheartj/ehad655.1342Publisher landing page
- PDF URL
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https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.1342/53594359/ehad655.1342.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.1342/53594359/ehad655.1342.pdfDirect OA link when available
- Concepts
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Medicine, Conventional PCI, Internal medicine, Mace, Percutaneous coronary intervention, Cardiology, Coronary artery disease, Myocardial infarction, Revascularization, Clinical endpoint, Randomized controlled trialTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- Related works (count)
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10Other works algorithmically related by OpenAlex
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