Key result
Premature ACS patients face higher in-hospital mortality after PCI than older patients, despite similar MACCE.
Why the study?
The prevalence of premature ACS has dramatically increased, particularly in developing countries, but data regarding risk factors and outcomes in these patients remain inconsistent.
Does premature age in ACS patients undergoing PCI affect risk factor profiles and clinical outcomes compared to older patients?
Cohort (n=13,541)
No
Does premature age in ACS patients undergoing PCI affect risk factor profiles and clinical outcomes compared to older patients?
Premature ACS patients undergoing PCI have a distinct risk factor profile and higher adjusted in-hospital mortality compared to older patients, emphasizing the need for rigorous secondary prevention in young adults.
May warrant heightened in-hospital monitoring after PCI in premature ACS; leaves open age-specific prevention strategies.
BACKGROUND: The prevalence of acute coronary syndrome (ACS) among young adults (premature ACS) has dramatically increased in recent years, especially in developing countries. Yet, the data on these patients' attributed risk factors and outcomes are inconsistent. In this study, we aimed to investigate these data in a cohort of premature ACS cases who underwent percutaneous coronary intervention (PCI) compared to older patients. HYPOTHESIS: We hypothesize that premature ACS patients undergoing PCI will exhibit different risk factor profiles and outcomes compared to non-premature patients. specifically, we anticipate that premature patients do not necessarily have better outcomes than non-premature. METHODS: Overall, 3142 and 10 399 patients were included in premature and non-premature groups, respectively. Patients' pre-operative, post-operative, and follow-up data were retrieved retrospectively from the Tehran Heart Center PCI databank. RESULTS: The mean age of premature and non-premature cohorts was 48.39 and 67 years, respectively. Patients were predominantly male in both groups. Family history of coronary artery disease (CAD), dyslipidemia, smoking, and opium addiction were more prevalent among the younger cohort. After adjustment, in-hospital mortality in younger patients was considerably higher, with all-cause mortality and major cardiovascular and cerebrovascular events (MACCE) exhibiting no noticeable difference among the two groups. CONCLUSIONS: Risk factor profile is different in young patients, and traditional cardiovascular risk factors, such as hypertension and diabetes mellitus, are more prevalent among older adults. Younger age is not equivalent to a better prognosis; hence, similar or even more caution should be taken into consideration regarding secondary prevention for these patients.
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Fallahzadeh et al. (2023) conducted a cohort in Acute coronary syndrome (ACS) (n=13,541). Premature ACS (younger age) vs. Non-premature ACS (older age) was evaluated on In-hospital mortality, all-cause mortality, and major cardiovascular and cerebrovascular events (MACCE). Premature ACS patients (mean age 48.39 years) undergoing PCI had higher adjusted in-hospital mortality than older patients, with no difference in all-cause mortality or MACCE.
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