Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention
ObjectivesWe assessed differences in risk profile and 3-year outcome between patients undergoing percutaneous coronary intervention (PCI) for premature and non-premature coronary artery disease (CAD).BackgroundThe prevalence of CAD increases with age, yet some individuals develop obstructive CAD at...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1160201/full |
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| author | Tineke H. Pinxterhuis Tineke H. Pinxterhuis Eline H. Ploumen Eline H. Ploumen Paolo Zocca Carine J. M. Doggen Carl E. Schotborgh Rutger L. Anthonio Ariel Roguin Peter W. Danse Edouard Benit Adel Aminian Marc Hartmann Gerard C. M. Linssen Clemens von Birgelen Clemens von Birgelen |
| author_facet | Tineke H. Pinxterhuis Tineke H. Pinxterhuis Eline H. Ploumen Eline H. Ploumen Paolo Zocca Carine J. M. Doggen Carl E. Schotborgh Rutger L. Anthonio Ariel Roguin Peter W. Danse Edouard Benit Adel Aminian Marc Hartmann Gerard C. M. Linssen Clemens von Birgelen Clemens von Birgelen |
| author_sort | Tineke H. Pinxterhuis |
| collection | DOAJ |
| description | ObjectivesWe assessed differences in risk profile and 3-year outcome between patients undergoing percutaneous coronary intervention (PCI) for premature and non-premature coronary artery disease (CAD).BackgroundThe prevalence of CAD increases with age, yet some individuals develop obstructive CAD at younger age.MethodsAmong participants in four randomized all-comers PCI trials, without previous coronary revascularization or myocardial infarction (MI), we compared patients with premature (men <50 years; women <55 years) and non-premature CAD. Various clinical endpoints were assessed, including multivariate analyses.ResultsOf 6,171 patients, 887(14.4%) suffered from premature CAD. These patients had fewer risk factors than patients with non-premature CAD, but were more often smokers (60.7% vs. 26.4%) and overweight (76.2% vs. 69.8%). In addition, premature CAD patients presented more often with ST-segment elevation MI and underwent less often treatment of multiple vessels, and calcified or bifurcated lesions. Furthermore, premature CAD patients had a lower all-cause mortality risk (adj.HR:0.23, 95%-CI: 0.10–0.52; p < 0.001), but target vessel revascularization (adj.HR:1.63, 95%-CI: 1.18–2.26; p = 0.003) and definite stent thrombosis risks (adj.HR:2.24, 95%-CI: 1.06–4.72; p = 0.034) were higher. MACE rates showed no statistically significant difference (6.6% vs. 9.4%; adj.HR:0.86, 95%-CI: 0.65–1.16; p = 0.33).ConclusionsAbout one out of seven PCI patients was treated for premature CAD. These patients had less complex risk profiles than patients with non-premature CAD; yet, their risk of repeated revascularization and stent thrombosis was higher. As lifetime event risk of patients with premature CAD is known to be particularly high, further efforts should be made to improve modifiable risk factors such as smoking and overweight.Clinical Trial Registration[clinicaltrials.gov], TWENTE [NCT01066650]; DUTCH PEERS [NCT01331707]; BIO-RESORT [NCT01674803]; BIONYX [NCT02508714]. |
| first_indexed | 2024-03-12T02:02:09Z |
| format | Article |
| id | doaj.art-5bf936d69ec2414aa17f6ea5ca4f4cc3 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-12T02:02:09Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5bf936d69ec2414aa17f6ea5ca4f4cc32023-09-07T12:21:32ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-06-011010.3389/fcvm.2023.11602011160201Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary interventionTineke H. Pinxterhuis0Tineke H. Pinxterhuis1Eline H. Ploumen2Eline H. Ploumen3Paolo Zocca4Carine J. M. Doggen5Carl E. Schotborgh6Rutger L. Anthonio7Ariel Roguin8Peter W. Danse9Edouard Benit10Adel Aminian11Marc Hartmann12Gerard C. M. Linssen13Clemens von Birgelen14Clemens von Birgelen15Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, NetherlandsDepartment of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, NetherlandsDepartment of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, NetherlandsDepartment of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, NetherlandsDepartment of Cardiology, Haga Hospital, The Hague, NetherlandsDepartment of Cardiology, Treant Zorggroep, Scheper Hospital, Emmen, NetherlandsDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera and B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa, IsraelDepartment of Cardiology, Rijnstate Hospital, Arnhem, NetherlandsDepartment of Cardiology, Jessa Hospital, Hasselt, BelgiumDepartment of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, BelgiumDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, NetherlandsDepartment of Cardiology, Ziekenhuisgroep Twente, Almelo, Hengelo, NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, NetherlandsDepartment of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, NetherlandsObjectivesWe assessed differences in risk profile and 3-year outcome between patients undergoing percutaneous coronary intervention (PCI) for premature and non-premature coronary artery disease (CAD).BackgroundThe prevalence of CAD increases with age, yet some individuals develop obstructive CAD at younger age.MethodsAmong participants in four randomized all-comers PCI trials, without previous coronary revascularization or myocardial infarction (MI), we compared patients with premature (men <50 years; women <55 years) and non-premature CAD. Various clinical endpoints were assessed, including multivariate analyses.ResultsOf 6,171 patients, 887(14.4%) suffered from premature CAD. These patients had fewer risk factors than patients with non-premature CAD, but were more often smokers (60.7% vs. 26.4%) and overweight (76.2% vs. 69.8%). In addition, premature CAD patients presented more often with ST-segment elevation MI and underwent less often treatment of multiple vessels, and calcified or bifurcated lesions. Furthermore, premature CAD patients had a lower all-cause mortality risk (adj.HR:0.23, 95%-CI: 0.10–0.52; p < 0.001), but target vessel revascularization (adj.HR:1.63, 95%-CI: 1.18–2.26; p = 0.003) and definite stent thrombosis risks (adj.HR:2.24, 95%-CI: 1.06–4.72; p = 0.034) were higher. MACE rates showed no statistically significant difference (6.6% vs. 9.4%; adj.HR:0.86, 95%-CI: 0.65–1.16; p = 0.33).ConclusionsAbout one out of seven PCI patients was treated for premature CAD. These patients had less complex risk profiles than patients with non-premature CAD; yet, their risk of repeated revascularization and stent thrombosis was higher. As lifetime event risk of patients with premature CAD is known to be particularly high, further efforts should be made to improve modifiable risk factors such as smoking and overweight.Clinical Trial Registration[clinicaltrials.gov], TWENTE [NCT01066650]; DUTCH PEERS [NCT01331707]; BIO-RESORT [NCT01674803]; BIONYX [NCT02508714].https://www.frontiersin.org/articles/10.3389/fcvm.2023.1160201/fullcoronary artery diseasedrug-eluting stent (DES)percutaneous coronary intervention (or PCI)premature coronary artery diseaseobstructive coronary artery disease |
| spellingShingle | Tineke H. Pinxterhuis Tineke H. Pinxterhuis Eline H. Ploumen Eline H. Ploumen Paolo Zocca Carine J. M. Doggen Carl E. Schotborgh Rutger L. Anthonio Ariel Roguin Peter W. Danse Edouard Benit Adel Aminian Marc Hartmann Gerard C. M. Linssen Clemens von Birgelen Clemens von Birgelen Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention Frontiers in Cardiovascular Medicine coronary artery disease drug-eluting stent (DES) percutaneous coronary intervention (or PCI) premature coronary artery disease obstructive coronary artery disease |
| title | Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention |
| title_full | Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention |
| title_fullStr | Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention |
| title_full_unstemmed | Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention |
| title_short | Impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention |
| title_sort | impact of premature coronary artery disease on adverse event risk following first percutaneous coronary intervention |
| topic | coronary artery disease drug-eluting stent (DES) percutaneous coronary intervention (or PCI) premature coronary artery disease obstructive coronary artery disease |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1160201/full |
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