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Long-Term Outcome of Acute Coronary Syndromes in Young Patients

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Abstract

Introduction

Acute coronary syndromes (ACS) in young patients are uncommon and their influence on morbidity and mortality in this population is still debated.

Aim

We investigated clinical and angiographic characteristics, risk factors and outcome in young patients diagnosed with ACS, compared with those of older patients, evaluating survival free from death and/or nonfatal myocardial infarction (MI) and/or coronary revascularization (primary endpoint), and then with respect to each component of the primary endpoint.

Methods

We retrospectively analyzed 1696 patients diagnosed with ACS between 2007 and 2013. 116 were aged ≤45 years (young adults), 1116 were >45 and <75 years (older adults) and 464 were ≥75 years.

Results

Young adults were mostly male, with a prevalent diagnosis of STEMI, had less frequently typical cardiovascular risk factors and lower prevalence of extensive coronary artery disease. Over a median 3 years follow up, survival free from composite endpoint was better in young than in older adult patients (11.2 vs. 24.2%; p = 0.001), mainly due to a lower rate of death while the occurrence of non fatal MI and of coronary revascularization was similar (7.8 vs. 8.7%, p = 0.86; 8.7 vs. 12.9%, p = 0.23 respectively). Diabetes was the strongest independent risk factor of worse prognosis in the young cohort (OR 3.47; 95% CI 1.01–11.9; p = 0.04).

Conclusions

Young adults showed peculiar clinical features and lower mortality compared with older adults. Morbidity was not different between the two populations, with diabetes independently associated with a worse prognosis.

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Authors and Affiliations

  1. Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Ospedale Sant’Andrea, Via di Grottarossa 1035-1039, 00189, Rome, Italy

    Giacomo Tini, Giulia Proietti, Matteo Casenghi, Marzia Colopi, Camillo Autore, Massimo Volpe & Beatrice Musumeci

  2. Department of Epidemiology, Lazio Regional Health Service, Rome, Italy

    Katia Bontempi

  3. IRCCS Neuromed, Pozzilli, IS, Italy

    Massimo Volpe

Authors
  1. Giacomo Tini
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  2. Giulia Proietti
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  3. Matteo Casenghi
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  4. Marzia Colopi
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  5. Katia Bontempi
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  6. Camillo Autore
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  7. Massimo Volpe
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  8. Beatrice Musumeci
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Corresponding author

Correspondence to Beatrice Musumeci.

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Authors have no conflicts of interest to declare.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tini, G., Proietti, G., Casenghi, M. et al. Long-Term Outcome of Acute Coronary Syndromes in Young Patients. High Blood Press Cardiovasc Prev 24, 77–84 (2017). https://doi.org/10.1007/s40292-017-0183-6

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  • DOI: https://doi.org/10.1007/s40292-017-0183-6

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