Key result
Young patients (≤40 years) with STEMI undergoing primary PCI had a 0% rate of major adverse clinical outcomes at 30 days, compared to 2.1% in patients aged 41-60 years and 5.3% in patients >60 years.
Why the study?
Do clinical outcomes and risk factors differ by age group in Indian patients with STEMI treated with primary PCI?
Observational (n=200)
No
Do clinical outcomes and risk factors differ by age group in Indian patients with STEMI treated with primary PCI?
Younger patients (≤40 years) with STEMI undergoing primary PCI have lower rates of diabetes, hypertension, and single vessel disease, and experience more favorable 30-day clinical outcomes compared to older patients.
Should not yet change practice; hypothesis-generating for age-related STEMI outcomes after PCI.
This study was carried out to analyze risk factors and short-term clinical outcomes in different age groups of Indian patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention. This prospective, non-randomized, and observational study was carried out at a tertiary care hospital. The patients who were treated with primary percutaneous coronary intervention for ST-elevation myocardial infarction at study center from December 2011 to September 2012 were included in the study. Study population is divided into three groups: Group-I consisted of patients with age ≤ 40 years, Group-II consisted of patients with age between 41 - 60 years and Group-III consisted of patients with age > 60 years. The primary end-point of the study was occurrence of major adverse clinical outcomes which were a composite of death, reinfarct, repeat percutaneous coronary intervention, major bleeding and emergency coronary artery bypass grafting at 30-day follow-up. A total of 200 patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention were included in the study. Among study population, 10 (5%) patients constituted Group-I, 96 (48%) patients constituted Group-II and 94 (47%) patients constituted Group-III. Diabetes (0% vs. 35.4% vs. 43.6%) and hypertension (10% vs. 35.4% vs. 44.7%) were more prevalent in Group-III as compared to Group-II and Group-I. The prevalence of single vessel disease was significantly higher in the Group-I compared to Group-II and Group-III (80% vs. 41.66% vs. 17%). At 30-day clinical follow-up, the rate of occurrence of major adverse clinical outcomes in Group-I, Group-II and Group-III is 0%, 2% and 5.4%, respectively. The young ST-elevation myocardial infarction patients had lower incidences of diabetes and hypertension compared with elderly patients. The young age group had more favorable in-hospital and 30-day clinical outcomes.
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Manzil et al. (2015) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=200). Young age (≤40 years) vs. Older age (>40 years) was evaluated on Major adverse clinical outcomes (composite of death, reinfarct, repeat PCI, major bleeding, and emergency CABG) at 30-day follow-up. Young patients (≤40 years) with STEMI undergoing primary PCI had a 0% rate of major adverse clinical outcomes at 30 days, compared to 2.1% in patients aged 41-60 years and 5.3% in patients >60 years.
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