Short and long-term survival after primary percutaneous coronary intervention in young patients with ST-elevation myocardial infarction

Homa Waziri, Erik Jørgensen, Henning Kelbæk, Martin Stagmo, Frants Pedersen, Bo Lagerqvist, Stefan James, Lars Køber, Kristian Wachtell

15 Citations (Scopus)

Abstract

The long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) aged 45 years or younger and differences according to gender have not been well characterized. Methods We included 16,685 consecutive STEMI patients from 2003 to 2012 (67,992 patient-years follow-up) from the Eastern Danish Heart Registry and the Swedish Coronary Angiography and Angioplasty Registry who were treated with primary percutaneous coronary intervention (PCI). Results We identified 1026 (6.2%) patients up to 45 years of age (mean age: 40.7 vs. 66.3 years, P < 0.001). Patients in the young group were predominantly men (79.7% vs. 71.9%) and smokers (71.2% vs. 44.2%, P < 0.001) but with a lower prevalence of hypertension (17.3% vs. 39.3%), hyperlipidemia (18.0% vs. 23.8%), diabetes (9.0% vs. 12.4%) and previous myocardial infarction (6.9% vs. 12.2%, all P < 0.001) compared with older patients. Young patients had a 0.8% annual mortality. During the follow-up period 6.3% of young patients died vs. 28.5% of older patients (P < 0.001). Both 30-day-mortality (adjusted hazard ratio [HR] = 0.26, 95% confidence interval [CI]: 0.12-0.54, P < 0.001) and mortality after 30 days and onwards (HR = 0.25, CI: 0.17-0.37, P < 0.001) were significantly lower in the young group. There was no difference in short-term (HR = 0.78, CI: 0.32-1.90, P = 0.59) or long-term (HR = 0.62, CI: 0.33-1.91, P = 0.59) mortality between women and men in the young group (HR = 0.79, CI: 0.21-1.80, P = 0.39). Conclusions STEMI patients, aged 45 years or younger, have an excellent prognosis after treatment with primary PCI. Long-term annual survival is more than 99% in these patients. Young women with STEMI do not have a worse long-term prognosis than young men with STEMI.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume203
Pages (from-to)697-701
Number of pages5
ISSN0167-5273
DOIs
Publication statusPublished - 15 Jan 2016

Keywords

  • Adult
  • Cause of Death
  • Coronary Angiography
  • Denmark
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Percutaneous Coronary Intervention
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Sweden
  • Time Factors
  • Journal Article
  • Multicenter Study

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