Two-Decade Trends in the Prevalence of Atherosclerotic Risk Factors, Coronary Plaque Morphology, and Outcomes in Adults Aged less than or equal to 45 Years Undergoing Percutaneous Coronary Intervention
Data are limited about the prevalence trends of risk factors, lesion morphology, and clinical outcomes of coronary artery disease in patients, aged less than or equal to 45 years, undergoing percutaneous coronary intervention (PCI), between the bare-metal stent (BMS; 1994 to 2002) and drug-eluting s...
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| Veröffentlicht in: | The American journal of cardiology 2016-10, Vol.118 (7), p.939-943 |
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| container_title | The American journal of cardiology |
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| creator | Poddar, Kanhaiya L Modi, Dhruv K Wayangankar, Siddharth Thakkar, Badal Krishnaswamy, Amar Kumari, Meera Bdair, Hazem Sud, Karan Parashar, Akhil Raza, Mohammad Qasim Faruqui, Raquib Agarwal, Shikhar Banerjee, Kinjal Tuzcu, EMurat Kapadia, Samir R |
| description | Data are limited about the prevalence trends of risk factors, lesion morphology, and clinical outcomes of coronary artery disease in patients, aged less than or equal to 45 years, undergoing percutaneous coronary intervention (PCI), between the bare-metal stent (BMS; 1994 to 2002) and drug-eluting stent (DES; 2003 to 2012) eras. From the PCI database at the Cleveland Clinic, we identified 1,640 patients aged less than or equal to 45 years and without a history of coronary artery bypass grafting who underwent PCI from 1994 to 2012. There were 883 patients in the BMS era cohort with a mean follow-up period of 13.15 years and 757 in the DES era cohort with a mean follow-up of 5.02 years. The DES era had more obese (51.8% vs 44.7%, p |
| doi_str_mv | 10.1016/j.amjcard.2016.06.055 |
| format | Article |
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From the PCI database at the Cleveland Clinic, we identified 1,640 patients aged less than or equal to 45 years and without a history of coronary artery bypass grafting who underwent PCI from 1994 to 2012. There were 883 patients in the BMS era cohort with a mean follow-up period of 13.15 years and 757 in the DES era cohort with a mean follow-up of 5.02 years. The DES era had more obese (51.8% vs 44.7%, p <0.001) and diabetes (23.0% vs 19.5%, p = 0.09) patients. DES era patients had more B2/C lesions (74.0% vs 32.5%, p <0.001), more severe preprocedural stenosis (86.1 plus or minus 12.9 vs 72.2 plus or minus 21.3, p <0.001), and longer lesions (15.5 plus or minus 9.9 vs 9.6 plus or minus 6.8, p <0.001). No difference was observed in the 30-day mortality between the DES and BMS eras. Irrespective of era, diabetics had worse long-term mortality (19.4% vs 9.3%, p <0.001) compared with nondiabetics. Obese patients had similar long-term outcomes compared with nonobese patients. In conclusion, patients aged less than or equal to 45 years, who underwent a PCI procedure in the DES era had worse risk factor profiles, including obesity, compared with patients in the BMS era. They also had more complex lesions. Procedural and long-term outcomes of these patients have not changed between the 2 eras. Young diabetic patients have worse long-term outcomes compared with nondiabetics.</description><identifier>ISSN: 0002-9149</identifier><identifier>DOI: 10.1016/j.amjcard.2016.06.055</identifier><language>eng</language><ispartof>The American journal of cardiology, 2016-10, Vol.118 (7), p.939-943</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,64387</link.rule.ids></links><search><creatorcontrib>Poddar, Kanhaiya L</creatorcontrib><creatorcontrib>Modi, Dhruv K</creatorcontrib><creatorcontrib>Wayangankar, Siddharth</creatorcontrib><creatorcontrib>Thakkar, Badal</creatorcontrib><creatorcontrib>Krishnaswamy, Amar</creatorcontrib><creatorcontrib>Kumari, Meera</creatorcontrib><creatorcontrib>Bdair, Hazem</creatorcontrib><creatorcontrib>Sud, Karan</creatorcontrib><creatorcontrib>Parashar, Akhil</creatorcontrib><creatorcontrib>Raza, Mohammad Qasim</creatorcontrib><creatorcontrib>Faruqui, Raquib</creatorcontrib><creatorcontrib>Agarwal, Shikhar</creatorcontrib><creatorcontrib>Banerjee, Kinjal</creatorcontrib><creatorcontrib>Tuzcu, EMurat</creatorcontrib><creatorcontrib>Kapadia, Samir R</creatorcontrib><title>Two-Decade Trends in the Prevalence of Atherosclerotic Risk Factors, Coronary Plaque Morphology, and Outcomes in Adults Aged less than or equal to 45 Years Undergoing Percutaneous Coronary Intervention</title><title>The American journal of cardiology</title><description>Data are limited about the prevalence trends of risk factors, lesion morphology, and clinical outcomes of coronary artery disease in patients, aged less than or equal to 45 years, undergoing percutaneous coronary intervention (PCI), between the bare-metal stent (BMS; 1994 to 2002) and drug-eluting stent (DES; 2003 to 2012) eras. From the PCI database at the Cleveland Clinic, we identified 1,640 patients aged less than or equal to 45 years and without a history of coronary artery bypass grafting who underwent PCI from 1994 to 2012. There were 883 patients in the BMS era cohort with a mean follow-up period of 13.15 years and 757 in the DES era cohort with a mean follow-up of 5.02 years. The DES era had more obese (51.8% vs 44.7%, p <0.001) and diabetes (23.0% vs 19.5%, p = 0.09) patients. DES era patients had more B2/C lesions (74.0% vs 32.5%, p <0.001), more severe preprocedural stenosis (86.1 plus or minus 12.9 vs 72.2 plus or minus 21.3, p <0.001), and longer lesions (15.5 plus or minus 9.9 vs 9.6 plus or minus 6.8, p <0.001). No difference was observed in the 30-day mortality between the DES and BMS eras. Irrespective of era, diabetics had worse long-term mortality (19.4% vs 9.3%, p <0.001) compared with nondiabetics. Obese patients had similar long-term outcomes compared with nonobese patients. In conclusion, patients aged less than or equal to 45 years, who underwent a PCI procedure in the DES era had worse risk factor profiles, including obesity, compared with patients in the BMS era. They also had more complex lesions. Procedural and long-term outcomes of these patients have not changed between the 2 eras. 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From the PCI database at the Cleveland Clinic, we identified 1,640 patients aged less than or equal to 45 years and without a history of coronary artery bypass grafting who underwent PCI from 1994 to 2012. There were 883 patients in the BMS era cohort with a mean follow-up period of 13.15 years and 757 in the DES era cohort with a mean follow-up of 5.02 years. The DES era had more obese (51.8% vs 44.7%, p <0.001) and diabetes (23.0% vs 19.5%, p = 0.09) patients. DES era patients had more B2/C lesions (74.0% vs 32.5%, p <0.001), more severe preprocedural stenosis (86.1 plus or minus 12.9 vs 72.2 plus or minus 21.3, p <0.001), and longer lesions (15.5 plus or minus 9.9 vs 9.6 plus or minus 6.8, p <0.001). No difference was observed in the 30-day mortality between the DES and BMS eras. Irrespective of era, diabetics had worse long-term mortality (19.4% vs 9.3%, p <0.001) compared with nondiabetics. Obese patients had similar long-term outcomes compared with nonobese patients. In conclusion, patients aged less than or equal to 45 years, who underwent a PCI procedure in the DES era had worse risk factor profiles, including obesity, compared with patients in the BMS era. They also had more complex lesions. Procedural and long-term outcomes of these patients have not changed between the 2 eras. Young diabetic patients have worse long-term outcomes compared with nondiabetics.</abstract><doi>10.1016/j.amjcard.2016.06.055</doi></addata></record> |
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| title | Two-Decade Trends in the Prevalence of Atherosclerotic Risk Factors, Coronary Plaque Morphology, and Outcomes in Adults Aged less than or equal to 45 Years Undergoing Percutaneous Coronary Intervention |
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