Key result
Premature ACS shows no difference in adverse cardiovascular events post-PCI versus late-onset disease.
Why the study?
Few studies have compared the clinical manifestations and post-PCI adverse cardiovascular events between patients with premature ACS and late-onset ACS.
Does premature ACS compared to late-onset ACS affect the incidence of adverse cardiovascular events in patients undergoing PCI?
Cohort (n=726)
No
Does premature ACS compared to late-onset ACS affect the incidence of adverse cardiovascular events in patients undergoing PCI?
Odds Ratio: 1.666 (95% CI 0.403–6.89)
Absolute Event Rate: 12.6% vs 14.7%
p-value: p=0.481
Patients with premature ACS have a similar overall risk of adverse cardiovascular events following PCI compared to those with late-onset ACS, despite having fewer vascular lesions and being younger.
Similar post-PCI event rates in premature versus late-onset ACS; leaves open whether sex and hypertriglyceridemia warrant targeted prevention.
Few studies have compared the clinical manifestations of patients with premature acute coronary syndrome (ACS) and late-onset ACS as well as the adverse cardiovascular events following percutaneous coronary intervention (PCI). To investigate the clinicopathological characteristics of patients with premature ACS and adverse cardiovascular events following PCI, a total of 726 patients with ACS undergoing PCI were divided into two groups: A premature ACS group and a late-onset ACS group. Following discharge, all patients were followed-up for an average of 23.5±5.3 months. Clinical characteristics, Gensini scores, vascular lesions and adverse cardiovascular events were compared between the two groups. There were no significant differences in smoking, diabetes, ACS composition ratio, baseline treatment of coronary heart disease, high-density lipoprotein level and C-reactive protein levels between the two groups. Sex and hypertriglyceridemia were determined to be independent risk factors of premature ACS, while age, hypertension and a high Gensini score were independent risk factors for adverse cardiovascular events in patients with ACS following PCI. Furthermore, the prevalence of premature ACS was significantly higher in females. Although serum levels of fasting blood glucose, total cholesterol, triglycerides and low-density lipoprotein were also significantly higher in patients with premature ACS compared with patients with late-onset ACS, patients with premature ACS exhibited fewer vascular lesions compared with patients with late-onset ACS. Furthermore, the incidence of adverse cardiovascular events in patients with ACS following PCI did not differ significantly between premature and late-onset ACS groups. Taken together, these results suggest that female patients should be closely observed for early risk factors of premature ACS to prevent and reduce the occurrence of adverse cardiovascular events in patients with ACS following PCI.
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Shi et al. (2019) conducted a cohort in Acute coronary syndrome (n=726). Premature acute coronary syndrome vs. Late-onset acute coronary syndrome was evaluated on Adverse cardiovascular events (OR 1.666, 95% CI 0.403-6.890, p=0.481). Premature acute coronary syndrome was not associated with a significantly different risk of adverse cardiovascular events following percutaneous coronary intervention compared to late-onset disease (OR 1.666).
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