Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention

Yukiho Hirota, Mitsuaki Sawano, Yohei Numasawa, Ikuko Ueda, Shigetaka Noma, Masahiro Suzuki, Kentaro Hayashida, Shinsuke Yuasa, Yuichiro Maekawa, Shun Kosaka, Keiichi Fukuda

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

There is a growing interest in the optimizing care of acute coronary syndrome (ACS) in young patients, largely owing to their potential for longer life expectancy. Herein, we aimed to investigate the clinical characteristics and outcome of young ACS patients (e.g. under 60 year old) from a Japanese multicenter percutaneous coronary intervention (PCI) registry (KiCS-PCI). KiCS-PCI registered consecutive ACS patients from 15 institutions, and 1560 (24.0%) out of 6499 ACS-related PCI involved patients aged <60 years. In this group, prevalence of dyslipidemia, smoking and family history of premature coronary artery disease (CAD) was higher, while the other classical risk factors were lower when compared to the old patients. After adjustment for known confounders, presentation with cardiogenic shock (CS) before PCI (OR 32.57, 95% CI 12.06–87.97), culprit lesion of LMT (OR 7.53, 95% CI 1.26–44.98), multi-vessel disease (OR 3.82, 95% CI 1.37–10.63) and higher body mass index (OR 1.12, 95% CI 1.00–1.24) showed association with higher in-hospital mortality in young patients. Multi-vessel disease (OR 4.1, 95% CI 1.9–8.9) and chronic kidney disease (OR 3.56, 95% CI 2.26–5.68) were associated with CS presentation. CS presentation was inversely associated with classical risk factors such as hypertension (OR 0.61, 95% CI 0.38–0.96), family history of CAD (OR 0.49, 95% CI 0.25–0.96), and dyslipidemia (OR 0.45, 95% CI 0.29–0.71) and culprit lesion of RCA (OR 0.60, 95% CI 0.37–0.94). Overall, ACS in the younger population was observed frequently, accounting for a quarter of ACS-related PCI. CS was a harbinger for in-hospital mortality in these patients.

Original languageEnglish
Pages (from-to)154-162
Number of pages9
JournalCardiovascular Intervention and Therapeutics
Volume33
Issue number2
DOIs
Publication statusPublished - 2018 Apr 1

Fingerprint

Percutaneous Coronary Intervention
Acute Coronary Syndrome
Cardiogenic Shock
Dyslipidemias
Hospital Mortality
Coronary Artery Disease
Life Expectancy
Chronic Renal Insufficiency
Registries
Body Mass Index
Smoking
Hypertension
Population

Keywords

  • Acute coronary syndrome
  • Cardiogenic shock
  • Mortality
  • Young

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention. / Hirota, Yukiho; Sawano, Mitsuaki; Numasawa, Yohei; Ueda, Ikuko; Noma, Shigetaka; Suzuki, Masahiro; Hayashida, Kentaro; Yuasa, Shinsuke; Maekawa, Yuichiro; Kosaka, Shun; Fukuda, Keiichi.

In: Cardiovascular Intervention and Therapeutics, Vol. 33, No. 2, 01.04.2018, p. 154-162.

Research output: Contribution to journalArticle

@article{344d191a48924ba7acd8cab9e530271c,
title = "Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention",
abstract = "There is a growing interest in the optimizing care of acute coronary syndrome (ACS) in young patients, largely owing to their potential for longer life expectancy. Herein, we aimed to investigate the clinical characteristics and outcome of young ACS patients (e.g. under 60 year old) from a Japanese multicenter percutaneous coronary intervention (PCI) registry (KiCS-PCI). KiCS-PCI registered consecutive ACS patients from 15 institutions, and 1560 (24.0{\%}) out of 6499 ACS-related PCI involved patients aged <60 years. In this group, prevalence of dyslipidemia, smoking and family history of premature coronary artery disease (CAD) was higher, while the other classical risk factors were lower when compared to the old patients. After adjustment for known confounders, presentation with cardiogenic shock (CS) before PCI (OR 32.57, 95{\%} CI 12.06–87.97), culprit lesion of LMT (OR 7.53, 95{\%} CI 1.26–44.98), multi-vessel disease (OR 3.82, 95{\%} CI 1.37–10.63) and higher body mass index (OR 1.12, 95{\%} CI 1.00–1.24) showed association with higher in-hospital mortality in young patients. Multi-vessel disease (OR 4.1, 95{\%} CI 1.9–8.9) and chronic kidney disease (OR 3.56, 95{\%} CI 2.26–5.68) were associated with CS presentation. CS presentation was inversely associated with classical risk factors such as hypertension (OR 0.61, 95{\%} CI 0.38–0.96), family history of CAD (OR 0.49, 95{\%} CI 0.25–0.96), and dyslipidemia (OR 0.45, 95{\%} CI 0.29–0.71) and culprit lesion of RCA (OR 0.60, 95{\%} CI 0.37–0.94). Overall, ACS in the younger population was observed frequently, accounting for a quarter of ACS-related PCI. CS was a harbinger for in-hospital mortality in these patients.",
keywords = "Acute coronary syndrome, Cardiogenic shock, Mortality, Young",
author = "Yukiho Hirota and Mitsuaki Sawano and Yohei Numasawa and Ikuko Ueda and Shigetaka Noma and Masahiro Suzuki and Kentaro Hayashida and Shinsuke Yuasa and Yuichiro Maekawa and Shun Kosaka and Keiichi Fukuda",
year = "2018",
month = "4",
day = "1",
doi = "10.1007/s12928-017-0471-z",
language = "English",
volume = "33",
pages = "154--162",
journal = "Cardiovascular Intervention and Therapeutics",
issn = "1868-4300",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention

AU - Hirota, Yukiho

AU - Sawano, Mitsuaki

AU - Numasawa, Yohei

AU - Ueda, Ikuko

AU - Noma, Shigetaka

AU - Suzuki, Masahiro

AU - Hayashida, Kentaro

AU - Yuasa, Shinsuke

AU - Maekawa, Yuichiro

AU - Kosaka, Shun

AU - Fukuda, Keiichi

PY - 2018/4/1

Y1 - 2018/4/1

N2 - There is a growing interest in the optimizing care of acute coronary syndrome (ACS) in young patients, largely owing to their potential for longer life expectancy. Herein, we aimed to investigate the clinical characteristics and outcome of young ACS patients (e.g. under 60 year old) from a Japanese multicenter percutaneous coronary intervention (PCI) registry (KiCS-PCI). KiCS-PCI registered consecutive ACS patients from 15 institutions, and 1560 (24.0%) out of 6499 ACS-related PCI involved patients aged <60 years. In this group, prevalence of dyslipidemia, smoking and family history of premature coronary artery disease (CAD) was higher, while the other classical risk factors were lower when compared to the old patients. After adjustment for known confounders, presentation with cardiogenic shock (CS) before PCI (OR 32.57, 95% CI 12.06–87.97), culprit lesion of LMT (OR 7.53, 95% CI 1.26–44.98), multi-vessel disease (OR 3.82, 95% CI 1.37–10.63) and higher body mass index (OR 1.12, 95% CI 1.00–1.24) showed association with higher in-hospital mortality in young patients. Multi-vessel disease (OR 4.1, 95% CI 1.9–8.9) and chronic kidney disease (OR 3.56, 95% CI 2.26–5.68) were associated with CS presentation. CS presentation was inversely associated with classical risk factors such as hypertension (OR 0.61, 95% CI 0.38–0.96), family history of CAD (OR 0.49, 95% CI 0.25–0.96), and dyslipidemia (OR 0.45, 95% CI 0.29–0.71) and culprit lesion of RCA (OR 0.60, 95% CI 0.37–0.94). Overall, ACS in the younger population was observed frequently, accounting for a quarter of ACS-related PCI. CS was a harbinger for in-hospital mortality in these patients.

AB - There is a growing interest in the optimizing care of acute coronary syndrome (ACS) in young patients, largely owing to their potential for longer life expectancy. Herein, we aimed to investigate the clinical characteristics and outcome of young ACS patients (e.g. under 60 year old) from a Japanese multicenter percutaneous coronary intervention (PCI) registry (KiCS-PCI). KiCS-PCI registered consecutive ACS patients from 15 institutions, and 1560 (24.0%) out of 6499 ACS-related PCI involved patients aged <60 years. In this group, prevalence of dyslipidemia, smoking and family history of premature coronary artery disease (CAD) was higher, while the other classical risk factors were lower when compared to the old patients. After adjustment for known confounders, presentation with cardiogenic shock (CS) before PCI (OR 32.57, 95% CI 12.06–87.97), culprit lesion of LMT (OR 7.53, 95% CI 1.26–44.98), multi-vessel disease (OR 3.82, 95% CI 1.37–10.63) and higher body mass index (OR 1.12, 95% CI 1.00–1.24) showed association with higher in-hospital mortality in young patients. Multi-vessel disease (OR 4.1, 95% CI 1.9–8.9) and chronic kidney disease (OR 3.56, 95% CI 2.26–5.68) were associated with CS presentation. CS presentation was inversely associated with classical risk factors such as hypertension (OR 0.61, 95% CI 0.38–0.96), family history of CAD (OR 0.49, 95% CI 0.25–0.96), and dyslipidemia (OR 0.45, 95% CI 0.29–0.71) and culprit lesion of RCA (OR 0.60, 95% CI 0.37–0.94). Overall, ACS in the younger population was observed frequently, accounting for a quarter of ACS-related PCI. CS was a harbinger for in-hospital mortality in these patients.

KW - Acute coronary syndrome

KW - Cardiogenic shock

KW - Mortality

KW - Young

UR - http://www.scopus.com/inward/record.url?scp=85044838882&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044838882&partnerID=8YFLogxK

U2 - 10.1007/s12928-017-0471-z

DO - 10.1007/s12928-017-0471-z

M3 - Article

C2 - 28585049

AN - SCOPUS:85044838882

VL - 33

SP - 154

EP - 162

JO - Cardiovascular Intervention and Therapeutics

JF - Cardiovascular Intervention and Therapeutics

SN - 1868-4300

IS - 2

ER -