Clinical Outcomes and Risk Factor in Patients with STEMI Treated with Percutaneous Coronary Intervention

Abstract

This study was carried out to analyze risk factors and short-term clinical outcomes in different age groups of Indian patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention. This prospective, non-randomized, and observational study was carried out at a tertiary care hospital. The patients who were treated with primary percutaneous coronary intervention for ST-elevation myocardial infarction at study center from December 2011 to September 2012 were included in the study. Study population is divided into three groups: Group-I consisted of patients with age ≤ 40 years, Group-II consisted of patients with age between 41 - 60 years and Group-III consisted of patients with age > 60 years. The primary end-point of the study was occurrence of major adverse clinical outcomes which were a composite of death, reinfarct, repeat percutaneous coronary intervention, major bleeding and emergency coronary artery bypass grafting at 30-day follow-up. A total of 200 patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention were included in the study. Among study population, 10 (5%) patients constituted Group-I, 96 (48%) patients constituted Group-II and 94 (47%) patients constituted Group-III. Diabetes (0% vs. 35.4% vs. 43.6%) and hypertension (10% vs. 35.4% vs. 44.7%) were more prevalent in Group-III as compared to Group-II and Group-I. The prevalence of single vessel disease was significantly higher in the Group-I compared to Group-II and Group-III (80% vs. 41.66% vs. 17%). At 30-day clinical follow-up, the rate of occurrence of major adverse clinical outcomes in Group-I, Group-II and Group-III is 0%, 2% and 5.4%, respectively. The young ST-elevation myocardial infarction patients had lower incidences of diabetes and hypertension compared with elderly patients. The young age group had more favorable in-hospital and 30-day clinical outcomes.

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Manzil, A. , Radhakrishnan, V. and Rajan, J. (2015) Clinical Outcomes and Risk Factor in Patients with STEMI Treated with Percutaneous Coronary Intervention. International Journal of Clinical Medicine, 6, 753-758. doi: 10.4236/ijcm.2015.610101.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Murray, C.J.L. and Lopez, A.D. (1997) Global Mortality, Disability, and the Contribution of Risk Factors: Global Burden of Disease Study. The Lancet, 349, 1436-1442.
http://dx.doi.org/10.1016/S0140-6736(96)07495-8
[2] Murray, C.J.L. and Lopez, A.D. (1997) Mortality by Cause for Eight Regions of the World: Global Burden of Disease Study. The Lancet, 349, 1269-1276.
http://dx.doi.org/10.1016/S0140-6736(96)07493-4
[3] Zimmerman, F.H., Cameron, A., Fisher, L.D. and Ng, G. (1995) Myocardial Infarction in Young Adults: Angiographic Characterization, Risk Factors and Prognosis (Coronary Artery Surgery Study Registry). Journal of the American College of Cardiology, 26, 654-661.
http://dx.doi.org/10.1016/0735-1097(95)00254-2
[4] De Luca, G., Dirksen, M.T., Spaulding, C., Kelbæk, H., Schalij, M., Thuesen, L., et al. (2015) Impact of Age on Long-Term Outcome after Primary Angioplasty with Bare-Metal or Drug-Eluting Stent (from the DESERT Cooperation). American Journal of Cardiology, 112, 181-186.
http://dx.doi.org/10.1016/j.amjcard.2013.03.012
[5] Imazio, M., Bobbio, M., Bergerone, S., Barlera, S. and Maggioni, A.P. (1998) Clinical and Epidemiological Characteristics of Juvenile Myocardial Infarction in Italy: The GISSI Experience. Giornale Italiano di Cardiologia, 28, 505-512.
[6] Chua, S.K., Hung, H.F., Shyu, K.G., Cheng, J.J., Chiu, C.Z., Chang, C.M., et al. (2010) Acute ST-Elevation Myocardial Infarction in Young Patients: 15 Years of Experience in a Single Center. Clinical Cardiology, 33, 140-148.
http://dx.doi.org/10.1002/clc.20718
[7] Wang, Y.Y., Li, T., Liu, Y.W., Liu, B.J., Wang, Y., Hu, X.M., et al. (2014) Analysis of Risk Factors of ST-Segment Elevation Myocardial Infarction in Young Patients. BMC Cardiovascular Disorders, 14, 179.
http://dx.doi.org/10.1186/1471-2261-14-179
[8] Weinberger, I., Rotenberg, Z., Fuchs, J., Sagy, A., Friedmann, J. and Agmon, J. (1987) Myocardial Infarction in Young Adults under 30 Years: Risk Factors and Clinical Course. Clinical Cardiology, 10, 9-15.
http://dx.doi.org/10.1002/clc.4960100104
[9] Shiraishi, J., Kohno, Y., Yamaguchi, S., Arihara, M., Hadase, M., Hyogo, M., et al. (2005) Acute Myocardial Infarction in Young Japanese Adults. Circulation Journal, 69, 1454-1458.
http://dx.doi.org/10.1253/circj.69.1454
[10] Shiraishi, J., Kohno, Y., Yamaguchi, S., Arihara, M., Hadase, M., Hyogo, M., et al. (2006) Medium-Term Prognosis of Young Japanese Adults Having Acute Myocardial Infarction. Circulation Journal, 70, 518-524.
http://dx.doi.org/10.1253/circj.70.518
[11] Chen, Y.-L., Bhasin, A., Youssef, A.A., Wu, C.-J., Yang, C.-H., Hsieh, Y.-K., et al. (2009) Prognostic Factors and Outcomes in Young Chinese Patients with Acute Myocardial Infarction Undergoing Primary Coronary Angioplasty. International Heart Journal, 50, 1-11.
http://dx.doi.org/10.1536/ihj.50.1
[12] Kanitz, M.G., Giovannucci, S.J., Jones, J.S. and Mott, M. (1996) Myocardial Infarction in Young Adults: Risk Factors and Clinical Features. The Journal of Emergency Medicine, 14, 139-145.
http://dx.doi.org/10.1016/0736-4679(95)02089-6
[13] Puricel, S., Lehner, C., Oberhänsli, M., Rutz, T., Togni, M., Stadelmann, M., et al. (2013) Acute Coronary Syndrome in Patients Younger than 30 Years—Aetiologies, Baseline Characteristics and Long-Term Clinical Outcome. Swiss Medical Weekly, 143, w13816.
http://dx.doi.org/10.4414/smw.2013.13816
[14] Colkesen, A.Y., Acil, T., Demircan, S., Sezgin, A.T. and Mu-derrisoglu, H. (2008) Coronary Lesion Type, Location, and Characteristics of Acute ST Elevation Myocardial Infarction in Young Adults under 35 Years of Age. Coronary Artery Disease, 19, 345-347.
http://dx.doi.org/10.1097/MCA.0b013e3283030b3b
[15] Hosseini, S.K., Soleimani, A., Karimi, A.A., Sadeghian, S., Darabian, S., Abbasi, S.H., et al. (2009) Clinical Features, Management and In-Hospital Outcome of ST Elevation Myocardial Infarction (STEMI) in Young Adults under 40 Years of Age. Monaldi Archives for Chest Disease, 72, 71-76.
[16] Lee, S.H., Kim, J.H., Jeong, M.H., Park, H., Jeong, Y.A., Ahn, Y., et al. (2015) Clinical Characteristics and Outcomes of Acute ST-Segment Elevation Myocardial Infarction in Younger Korean Adults. Korean Circulation Journal, 45, 275-284.
http://dx.doi.org/10.4070/kcj.2015.45.4.275
[17] Karim, M.A., Majumder, A.A.S., Islam, K.Q., Alam, M.B., Paul, M.L., Islam, M.S., et al. (2015) Risk Factors and In-Hospital Outcome of Acute ST Segment Elevation Myocardial Infarction in Young Bangladeshi Adults. BMC Cardiovascular Disorders, 15, 73.
http://dx.doi.org/10.1186/s12872-015-0069-2
[18] Waziri, H., Jørgensen, E., Kelbæk, H., Stagmo, M., Pedersen, F., Lagerqvist, B., et al. (2015) Short and Long-Term Survival after Primary Percutaneous Coronary Intervention in Young Patients with ST-Elevation Myocardial Infarction. International Journal of Cardiology.
http://dx.doi.org/10.1016/j.ijcard.2015.09.012

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