First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents

First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents

Abstract Aims Patients with premature coronary artery disease (CAD) have a higher incidence of myocardial infarction (MI) than patients with non-premature CAD. The aim of the present study is to asess differences in clinical outcome after a first acute MI, percutaneously treated with new-generation...

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Veröffentlicht in:European heart journal. Acute cardiovascular care 2023-11, Vol.12 (11), p.774-781
Hauptverfasser: Pinxterhuis, Tineke H, Ploumen, Eline H, Doggen, Carine J M, Hartmann, Marc, Schotborgh, Carl E, Anthonio, Rutger L, Roguin, Ariel, Danse, Peter W, Benit, Edouard, Aminian, Adel, Linssen, Gerard C M, von Birgelen, Clemens
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container_issue 11
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container_title European heart journal. Acute cardiovascular care
container_volume 12
creator Pinxterhuis, Tineke H
Ploumen, Eline H
Doggen, Carine J M
Hartmann, Marc
Schotborgh, Carl E
Anthonio, Rutger L
Roguin, Ariel
Danse, Peter W
Benit, Edouard
Aminian, Adel
Linssen, Gerard C M
von Birgelen, Clemens
description Abstract Aims Patients with premature coronary artery disease (CAD) have a higher incidence of myocardial infarction (MI) than patients with non-premature CAD. The aim of the present study is to asess differences in clinical outcome after a first acute MI, percutaneously treated with new-generation drug-eluting stents between patients with premature and non-premature CAD. Methods and results We pooled and analysed the characteristics and clinical outcome of all patients with a first MI (and no previous coronary revascularization) at time of enrolment, in four large-scale drug-eluting stent trials. Coronary artery disease was classified premature in men aged
doi_str_mv 10.1093/ehjacc/zuad098
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The aim of the present study is to asess differences in clinical outcome after a first acute MI, percutaneously treated with new-generation drug-eluting stents between patients with premature and non-premature CAD. Methods and results We pooled and analysed the characteristics and clinical outcome of all patients with a first MI (and no previous coronary revascularization) at time of enrolment, in four large-scale drug-eluting stent trials. Coronary artery disease was classified premature in men aged &lt;50 and women &lt;55 years. Myocardial infarction patients with premature and non-premature CAD were compared. The main endpoint was major adverse cardiac events (MACE): all-cause mortality, any MI, emergent coronary artery bypass surgery, or clinically indicated target lesion revascularization. Of 3323 patients with a first MI, 582 (17.5%) had premature CAD. These patients had lower risk profiles and underwent less complex interventional procedures than patients with non-premature CAD. At 30-day follow-up, the rates of MACE [hazard ratio (HR): 0.22, 95% confidence interval (CI): 0.07–0.71; P = 0.005), MI (HR: 0.22, 95% CI: 0.05–0.89; P = 0.020), and target vessel failure (HR: 0.30, 95% CI: 0.11–0.82; P = 0.012) were lower in patients with premature CAD. At 1 year, premature CAD was independently associated with lower rates of MACE (adjusted HR: 0.50, 95% CI: 0.26–0.96; P = 0.037) and all-cause mortality (adjusted HR: 0.24, 95% CI: 0.06–0.98; P = 0.046). At 2 years, premature CAD was independently associated with lower mortality (adjusted HR: 0.16, 95% CI: 0.05–0.50; P = 0.002). Conclusions First MI patients with premature CAD, treated with contemporary stents, showed lower rates of MACE and all-cause mortality than patients with non-premature CAD, which is most likely related to differences in cardiovascular risk profile. TWENTE trials: TWENTE I, clinicaltrials.gov: NCT01066650), DUTCH PEERS (TWENTE II, NCT01331707), BIO-RESORT (TWENTE III, NCT01674803), and BIONYX (TWENTE IV, NCT02508714) Graphical Abstract Graphical Abstract Comparison of patients with premature and non-premature coronary artery disease. CAD, coronary artery disease; CI, confidence interval; HR, hazard ratio.</description><identifier>ISSN: 2048-8726</identifier><identifier>EISSN: 2048-8734</identifier><identifier>DOI: 10.1093/ehjacc/zuad098</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>European heart journal. Acute cardiovascular care, 2023-11, Vol.12 (11), p.774-781</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c346t-31a43bfd6ec6e4ea66e6cdf1a697230921a8bc49610c322a46400e9d4ed83dec3</citedby><cites>FETCH-LOGICAL-c346t-31a43bfd6ec6e4ea66e6cdf1a697230921a8bc49610c322a46400e9d4ed83dec3</cites><orcidid>0000-0002-9050-8742 ; 0000-0002-5128-2832</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids></links><search><creatorcontrib>Pinxterhuis, Tineke H</creatorcontrib><creatorcontrib>Ploumen, Eline H</creatorcontrib><creatorcontrib>Doggen, Carine J M</creatorcontrib><creatorcontrib>Hartmann, Marc</creatorcontrib><creatorcontrib>Schotborgh, Carl E</creatorcontrib><creatorcontrib>Anthonio, Rutger L</creatorcontrib><creatorcontrib>Roguin, Ariel</creatorcontrib><creatorcontrib>Danse, Peter W</creatorcontrib><creatorcontrib>Benit, Edouard</creatorcontrib><creatorcontrib>Aminian, Adel</creatorcontrib><creatorcontrib>Linssen, Gerard C M</creatorcontrib><creatorcontrib>von Birgelen, Clemens</creatorcontrib><title>First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents</title><title>European heart journal. Acute cardiovascular care</title><description>Abstract Aims Patients with premature coronary artery disease (CAD) have a higher incidence of myocardial infarction (MI) than patients with non-premature CAD. The aim of the present study is to asess differences in clinical outcome after a first acute MI, percutaneously treated with new-generation drug-eluting stents between patients with premature and non-premature CAD. Methods and results We pooled and analysed the characteristics and clinical outcome of all patients with a first MI (and no previous coronary revascularization) at time of enrolment, in four large-scale drug-eluting stent trials. Coronary artery disease was classified premature in men aged &lt;50 and women &lt;55 years. Myocardial infarction patients with premature and non-premature CAD were compared. The main endpoint was major adverse cardiac events (MACE): all-cause mortality, any MI, emergent coronary artery bypass surgery, or clinically indicated target lesion revascularization. Of 3323 patients with a first MI, 582 (17.5%) had premature CAD. These patients had lower risk profiles and underwent less complex interventional procedures than patients with non-premature CAD. At 30-day follow-up, the rates of MACE [hazard ratio (HR): 0.22, 95% confidence interval (CI): 0.07–0.71; P = 0.005), MI (HR: 0.22, 95% CI: 0.05–0.89; P = 0.020), and target vessel failure (HR: 0.30, 95% CI: 0.11–0.82; P = 0.012) were lower in patients with premature CAD. At 1 year, premature CAD was independently associated with lower rates of MACE (adjusted HR: 0.50, 95% CI: 0.26–0.96; P = 0.037) and all-cause mortality (adjusted HR: 0.24, 95% CI: 0.06–0.98; P = 0.046). At 2 years, premature CAD was independently associated with lower mortality (adjusted HR: 0.16, 95% CI: 0.05–0.50; P = 0.002). Conclusions First MI patients with premature CAD, treated with contemporary stents, showed lower rates of MACE and all-cause mortality than patients with non-premature CAD, which is most likely related to differences in cardiovascular risk profile. TWENTE trials: TWENTE I, clinicaltrials.gov: NCT01066650), DUTCH PEERS (TWENTE II, NCT01331707), BIO-RESORT (TWENTE III, NCT01674803), and BIONYX (TWENTE IV, NCT02508714) Graphical Abstract Graphical Abstract Comparison of patients with premature and non-premature coronary artery disease. CAD, coronary artery disease; CI, confidence interval; HR, hazard ratio.</description><issn>2048-8726</issn><issn>2048-8734</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkbFOwzAQhiMEElXpyuwRhrZO7LoOG6ooICGxwBxdzxfqqomD7QiVR-IpcWlhxcudTt_nO-nPssucT3JeiimtN4A4_ezB8FKfZIOCSz3WcyFP__pCnWejEDY8vTlXUotB9rW0PkTW7ByCNxa2zLY1eIzWtallHURLbQzsw8Y16zw1EHtPDJ13LfgdAx8pFWMDQaCb5AT7tk6CbaP71RmuwQMm0oZoMTBoDXN9RNcQgzrNWfQEsdmzP5vQtZGazvn9jhD3J1xkZzVsA42OdZi9Lu9eFg_jp-f7x8Xt0xiFVHEscpBiVRtFqEgSKEUKTZ2DKueF4GWRg16hLFXOURQFSCU5p9JIMloYQjHMrg7_dt699xRi1diAtN1CS64PVaFncy35TOuETg4oeheCp7rqvG3SyVXOq30u1SGX6phLEq4Pguu7_9hvjRuYDA</recordid><startdate>20231116</startdate><enddate>20231116</enddate><creator>Pinxterhuis, Tineke H</creator><creator>Ploumen, Eline H</creator><creator>Doggen, Carine J M</creator><creator>Hartmann, Marc</creator><creator>Schotborgh, Carl E</creator><creator>Anthonio, Rutger L</creator><creator>Roguin, Ariel</creator><creator>Danse, Peter W</creator><creator>Benit, Edouard</creator><creator>Aminian, Adel</creator><creator>Linssen, Gerard C M</creator><creator>von Birgelen, Clemens</creator><general>Oxford University Press</general><scope>TOX</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9050-8742</orcidid><orcidid>https://orcid.org/0000-0002-5128-2832</orcidid></search><sort><creationdate>20231116</creationdate><title>First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents</title><author>Pinxterhuis, Tineke H ; Ploumen, Eline H ; Doggen, Carine J M ; Hartmann, Marc ; Schotborgh, Carl E ; Anthonio, Rutger L ; Roguin, Ariel ; Danse, Peter W ; Benit, Edouard ; Aminian, Adel ; Linssen, Gerard C M ; von Birgelen, Clemens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c346t-31a43bfd6ec6e4ea66e6cdf1a697230921a8bc49610c322a46400e9d4ed83dec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pinxterhuis, Tineke H</creatorcontrib><creatorcontrib>Ploumen, Eline H</creatorcontrib><creatorcontrib>Doggen, Carine J M</creatorcontrib><creatorcontrib>Hartmann, Marc</creatorcontrib><creatorcontrib>Schotborgh, Carl E</creatorcontrib><creatorcontrib>Anthonio, Rutger L</creatorcontrib><creatorcontrib>Roguin, Ariel</creatorcontrib><creatorcontrib>Danse, Peter W</creatorcontrib><creatorcontrib>Benit, Edouard</creatorcontrib><creatorcontrib>Aminian, Adel</creatorcontrib><creatorcontrib>Linssen, Gerard C M</creatorcontrib><creatorcontrib>von Birgelen, Clemens</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal. Acute cardiovascular care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pinxterhuis, Tineke H</au><au>Ploumen, Eline H</au><au>Doggen, Carine J M</au><au>Hartmann, Marc</au><au>Schotborgh, Carl E</au><au>Anthonio, Rutger L</au><au>Roguin, Ariel</au><au>Danse, Peter W</au><au>Benit, Edouard</au><au>Aminian, Adel</au><au>Linssen, Gerard C M</au><au>von Birgelen, Clemens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents</atitle><jtitle>European heart journal. Acute cardiovascular care</jtitle><date>2023-11-16</date><risdate>2023</risdate><volume>12</volume><issue>11</issue><spage>774</spage><epage>781</epage><pages>774-781</pages><issn>2048-8726</issn><eissn>2048-8734</eissn><abstract>Abstract Aims Patients with premature coronary artery disease (CAD) have a higher incidence of myocardial infarction (MI) than patients with non-premature CAD. The aim of the present study is to asess differences in clinical outcome after a first acute MI, percutaneously treated with new-generation drug-eluting stents between patients with premature and non-premature CAD. Methods and results We pooled and analysed the characteristics and clinical outcome of all patients with a first MI (and no previous coronary revascularization) at time of enrolment, in four large-scale drug-eluting stent trials. Coronary artery disease was classified premature in men aged &lt;50 and women &lt;55 years. Myocardial infarction patients with premature and non-premature CAD were compared. The main endpoint was major adverse cardiac events (MACE): all-cause mortality, any MI, emergent coronary artery bypass surgery, or clinically indicated target lesion revascularization. Of 3323 patients with a first MI, 582 (17.5%) had premature CAD. These patients had lower risk profiles and underwent less complex interventional procedures than patients with non-premature CAD. At 30-day follow-up, the rates of MACE [hazard ratio (HR): 0.22, 95% confidence interval (CI): 0.07–0.71; P = 0.005), MI (HR: 0.22, 95% CI: 0.05–0.89; P = 0.020), and target vessel failure (HR: 0.30, 95% CI: 0.11–0.82; P = 0.012) were lower in patients with premature CAD. At 1 year, premature CAD was independently associated with lower rates of MACE (adjusted HR: 0.50, 95% CI: 0.26–0.96; P = 0.037) and all-cause mortality (adjusted HR: 0.24, 95% CI: 0.06–0.98; P = 0.046). At 2 years, premature CAD was independently associated with lower mortality (adjusted HR: 0.16, 95% CI: 0.05–0.50; P = 0.002). Conclusions First MI patients with premature CAD, treated with contemporary stents, showed lower rates of MACE and all-cause mortality than patients with non-premature CAD, which is most likely related to differences in cardiovascular risk profile. TWENTE trials: TWENTE I, clinicaltrials.gov: NCT01066650), DUTCH PEERS (TWENTE II, NCT01331707), BIO-RESORT (TWENTE III, NCT01674803), and BIONYX (TWENTE IV, NCT02508714) Graphical Abstract Graphical Abstract Comparison of patients with premature and non-premature coronary artery disease. CAD, coronary artery disease; CI, confidence interval; HR, hazard ratio.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/ehjacc/zuad098</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9050-8742</orcidid><orcidid>https://orcid.org/0000-0002-5128-2832</orcidid><oa>free_for_read</oa></addata></record>
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title First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents
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