Features of coronary artery patterns and percutaneous coronary intervention in patients with acute coronary syndrome and stable angina in patients aged below 40 years
- Authors: Abdullaev FZ1, Babaev NM1, Shikhieva LS1
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Affiliations:
- Topchibashev Research Centre of Surgery
- Issue: Vol 101, No 1 (2020)
- Pages: 18-24
- Section: Theoretical and clinical medicine
- URL: https://journals.rcsi.science/kazanmedj/article/view/19420
- DOI: https://doi.org/10.17816/KMJ2020-18
- ID: 19420
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Abstract
Aim. To study the features of risk profile, coronary artery patterns, and percutaneous coronary intervention in patients aged below 40 years with acute coronary syndrome and stable angina.
Methods. 208 patients with coronary artery disease aged below 40 years were examined: 51 (24.5%) patients aged 35 years and younger and 157 (75.5%) aged 36–40 years. 98 (47.1%) patients were admitted with acute coronary syndrome; 110 (52.9%) patients with stable angina. In groups of acute coronary syndrome and stable angina, myocardial infarction in past medical history was revealed in 23.5% and 36.4%, respectively. 165 patients underwent percutaneous coronary intervention: 84 (50.9%) with acute coronary syndrome; 81 (40.1%) with stable angina.
Results. Patients with stable angina differed by prevalence of myocardial infarction in past medical history, overweight, and family history of coronary artery disease. In group of acute coronary syndrome urban cohort prevailed as well as consumption of energy drinks among patients below 35 years; high prevalence of left ventricular dysfunction. Patients with acute coronary syndrome were characterized by involvement of one and three coronary arteries, and patients with stable angina — by pathology of two and three coronary arteries. Involvement of three coronary arteries was equal in both groups. In both groups, anterior interventricular artery was target coronary artery. Patients with stable angina had the same rate of right coronary artery and left circumflex artery involvement. In patients with stable angina, right coronary artery involvement was rarer, and left main coronary artery involvement was two times more frequent than in patients with acute coronary syndrome. The group with acute coronary syndrome was characterized by predominance of discrete lesions and coronary occlusions over diffuse lesions; and the group of stable angina — by diffuse lesions, and two-times less frequent coronary occlusions.
Conclusion. Among patients with acute coronary syndrome aged below 36 years, revascularization of right coronary artery was predominant, and among patients aged 36–40 years with acute coronary syndrome — revascularization of left circumflex artery.
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##article.viewOnOriginalSite##About the authors
F Z Abdullaev
Topchibashev Research Centre of Surgery
Author for correspondence.
Email: larisacardio@gmail.com
Azerbaijan, Baku, Azerbaijan
N M Babaev
Topchibashev Research Centre of Surgery
Email: larisacardio@gmail.com
Azerbaijan, Baku, Azerbaijan
L S Shikhieva
Topchibashev Research Centre of Surgery
Email: larisacardio@gmail.com
Azerbaijan, Baku, Azerbaijan
References
- Feijo I.P., Schmidt M.M., David R.B. et al. Clinical profile and outcomes of primary percutaneous coronary intervention in young patients. Rev. Bras. Cardiol. Invasiva. 2015; 23 (1): 48–51. doi: 10.1016/j.rbci.2015.01.006.
- Callachan E.L., Alsheikh-Ali A.A., Wallis L.A. Analysis of risk factors, presentation, and in-hospital events of very young patients presenting with ST-elevation myocardial infarction. J. Saudi. Heart Assoc. 2017; 29: 270–275. doi: 10.1016/j.jsha.2017.01.004.
- De Carvalho Cantarelli M.J., Castello H.J.Jr., Goncalves R. et al. Percutaneous coronary intervention in young patients. Rev. Bras. Cardiol. Invasiva. 2014; 22 (4): 353–358. doi: 10.1590/0104-1843000000059.
- Trzeciak P., Wozakowska-Kaplon B., Niedziela J. et al. Comparison of In-hospital and 12- and 36-month outcomes after acute coronary syndrome in men versus women <40 years (from the PL-ACS Registry). Am. J. Cardiol. 2016; 118 (9): 1300–1305. doi: 10.1016/j.amjcard.2016.07.067.
- Konishi H., Miyauchi K., Kasai T. et al. Long-term prognosis and clinical characteristics of young adults (≤40 years old) who underwent percutaneous coronary intervention. J. Cardiol. 2014; 64 (3): 171–174. doi: 10.1016/j.jjcc.2013.12.005.
- Chua Su-Kiat, Hung Huei-Fong, Shyu Kou-Gi et al. Acute ST-elevation myocardial infarction in young patients: 15 years of experience in a single center. Clin. Cardiol. 2010; 33 (3): 140–148. doi: 10.1002/clc.20718.
- Meliga E., De Benedictis M., Gagnor A. et.al. Long-term outcomes of percutaneous interventions with stent implantation in patients ≤40 years old. Am. J. Cardiol. 2012; 109 (12): 1717–1721. doi: 10.1016/j.amjcard.2012.01.400.
- Tewari S., Kumar S., Kapoor A. et.al. Premature coronary artery disease in North India: An angiography study of 1971 patients. Indian Heart J. 2005; 57 (4): 311–318. PMID: 16350676.
- Bhardwaj R., Kandoria A., Sharma R. Myocardial infarction in young adults — risk factors and pattern of coronary artery involvement. Nigerian Med. J. 2014; 55 (1): 44–47. doi: 10.4103/0300-1652.128161.
- Trzeciak P., Desperak P., Ciślak A. et al. Clinical characteristics, and in-hospital and long-term outcomes of stable angina treatment in patients below and over 40 years of age (from the PRESAGE registry). Kardiol. Pol. 2018; 76 (1): 186–194. doi: 10.5603/kp.a2017.0200.
- Tungsubutra W., Tresukosol D., Buddhari W. et al. Acute coronary syndrome in young adults: the Thai ACS Registry. J. Med. Assoc. Thai. 2007; 90 (1): 81–90. PMID: 18431890.
- Sinha S.K., Krishna V., Thakur R. et.al. Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in North India-AMIYA Study. ARYA Atheroscler. 2017; 13 (2): 79–87. PMID: 29026414.
- Walker N.J., Sites F.D., Shofer F.S., J.E. Hollander Characteristics and outcomes of young adults who present to the emergency department with chest pain. Acad. Emerg. Med. 2001; 8 (7): 703–708. doi: 10.1111/j.1553-2712.2001.tb00188.x.
- Pillay A.K., Naidoo D.P. Atherosclerotic disease is the predominant aetiology of acute coronary syndrome in young adults. CVJ of AFRICA. 2018; 29: 36–42. doi: 10.5830/CVJA-2017-035.
- Rajan B., Prabhakaran K. Risk factors and coronary angiographic profile of very young patients with acute myocardial infarction — a tertiary center experience. Stanley Med. J. 2017; 4 (1): 92–99.
- Pizarro V.R., Palacios-Rubio J., Cruz-Utrilla A. et al. ST-elevation myocardial infarction in patients ≤35 years of age. Am. J. Cardiol. 2019; 123 (6): 880–893. doi: 10.1016/j.amjcard.2018.12.017.
- Christus T., Shukkur A.M., Rashan I. et.al. Coronary artery disease in patients aged 35 or less — a different beast? Heart Views. 2011; 12: 7–11. doi: 10.4103/1995-705X.81550.
- Colkesen A.Y., Acil T., Demircan S. et al. Coronary lesion type, location, and characteristics of acute ST elevation myocardial infarction in young adults under 35 years of age. Coronary Art. Dis. 2008; 19 (5): 345–347. doi: 10.1097/MCA.0b013e3283030b3b.
- Hosseini S.K., Soleimani A., Salarifar M. et al. Demographics an angiographic findings in patients under 35 years of age with acute ST elevation myocardial infarction. J. Teh. Univ. Heart Ctr. 2011; 6 (2): 62–67. PMID: 23074607.
- Puricel S., Lehner C., Oberhänslia M. et.al. Acute coronary syndrome in patients younger than 30 years — aetiologies, baseline characteristics and long-term clinical outcome. Swiss. Med. Wkly. 2013; 143: w13816. doi: 10.4414/smw.2013.13816.
- Karimi A., Ahmadi S.H., Davoodi S. et.al. Early outcome of coronary artery bypass grafting in patients less than 40 years old comparing with elderly patients. J. Teh. Univ. Heart Ctr. 2007; 2: 95–99.
- Hurle A., Bernaeu E., Gomez-Vicente R., Ventura J. Coronary bypass surgery in young adults. A long — term survey. ICVTS. 2008; 7 (1): 126–129. doi: 10.1510/icvts.2007.160192.
- Fleissner F., Warnecke G., Cebotari S. et al. Coronary artery bypass grafting in young patients — insights into a distinct entity. J. Cardiothorac. Surg. 2015; 10: 65. doi: 10.1186/s13019-015-0266-1.
- Saraiva J., Antunes P.A., Antunes M.J. Coronary artery bypass surgery in young adults: excellent perioperative results and long-term survival. ICVTS. 2017; 24 (5): 691–695. doi: 10.1093/icvts/ivw407.