Results of percutaneous coronary angioplasty in patients < 40 years of age

• Published in: The American journal of cardiology Vol. 82; no. 2; pp. 135 - 139
• Main Authors: Ellis, Christopher J, French, John K, White, Harvey D, Ormiston, John A, Whitlock, Ralph M.L, Webster, Mark W.I
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.07.1998; Elsevier
• Subjects: Adult; Age Factors; Angioplasty, Balloon, Coronary - methods; Biological and medical sciences; Cardiology. Vascular system; Coronary Disease - therapy; Coronary heart disease; Female; Heart; Humans; Male; Medical sciences; Predictive Value of Tests; Risk Factors; Survival Analysis; Treatment Outcome; Human; Restenosis; Mortality; Young adult; Coronary artery; Risk factor; Instrumentation therapy; Cardiovascular disease; Complication; Instrumental dilatation; Coronary heart disease; Result
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(98)00318-X

This study examined factors influencing the outcome of percutaneous transluminal coronary angioplasty (PTCA) in patients <40 years of age. We followed 86 patients (mean age 37 years) treated from 1982 to 1994. The primary procedural success was 90%. At follow-up of 83 patients (97%) at a mean of 48 ± 33 months (range 5 to 147), there had been 3 late deaths. Actuarial survival at 5 and 10 years was 95% and 91%, respectively. At review only 5% of patients had class III angina and no patient had class IV angina. Repeat revascularization (PTCA alone in 21 [25%], surgery in 8 [10%], or both in 10 [12%] patients) was performed for restenosis in 29 patients (35%) and for disease progression at other sites in 10 patients (12%). On multivariate analysis, a history of diabetes mellitus (p <0.02) was the only factor associated with death or a subsequent cardiovascular event (myocardial infarction, stroke, or hospital admission with unstable angina). At follow-up, 20 patients (24%) still smoked, 64 (77%) had a total cholesterol level ≥200 mg/dl, 20 (24%) had a body mass index ≥30, and 15 (18%) were not taking aspirin. In conclusion, PTCA in adults <40 years of age has excellent early results with a low morbidity and mortality. The medium-term prognosis and control of symptoms was good, although by 5 years, further revascularization was required in almost half of the patients.