Martínez GG, Valdés CE, Cruz RLO, Cárdenas FY, Ravelo DR, Perera LCR

Language: Spanish
References: 32
Page: 155-164
PDF size: 109.55 Kb.

ABSTRACT

Introduction: Cardiovascular diseases in the young adults (younger than 51 years of age) increased their incidence in the last decade, with the consequent increase in the demand for medical attention and hospitalization.
Objectives: Describe the clinical and angiographic characteristics of a series of patients under 51 years of age undergoing percutaneous coronary intervention. Methods: A descriptive, cross-sectional study was conducted in clinical and angiographic characteristics of 373 patients aged 50 years or younger submitted to percutaneous coronary intervention at Dr. Carlos J. Finlay Central Military Hospital from September 2006 to December 2015. Results: Mean age was 45.7 ± 5.6 years, male (76.4%) predominated. The main risk factors were hypertension (67%) and smoking (63.5%). Acute coronary syndrome without ST segment elevation was the most frequent diagnosis (61.4%). The most affected vessels were the anterior descending artery and the right coronary artery. 61.7% of the lesions were located in the middle portion of the coronary vessels. The procedure was successful in 94.1% of the patients and three patients died. There was a significant association between risk factors and angiographic outcome.
Conclusions: Percutaneous coronary intervention in the adult under 50 years is not frequent, most of the procedures are successful and mortality is low. There was a significant association between the risk factors and the outcome of the procedure.

REFERENCES

1. World Health Organization. World Health Statistics 2014. Geneve: WHO Press; 2015 [cited 18 feb 2015 ]. Available from: http://www.who.int/gho/publications/world_health_statistics/en/

2. Programa de las Naciones Unidas para el desarrollo. Informe sobre Desarrollo Humano 2013. El ascenso del Sur: progreso humano en un mundo diverso. Nueva York: PNUD; 2013.

3. Dirección Nacional de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2015. La Habana: MINSAP; 2016.

4. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. Guía ESC 2015 sobre el tratamiento de los síndromes coronarios agudos en pacientes sin elevación persistente del segmento ST. Rev Esp Cardiol. 2015;68(12):1125.e1-e64.

5. Roger LV, Go SA, Lloyd-Jones MD, Benjamin JE, Berry DJ, Borden BW,et al. Heart Disease and Stroke Statistics-2012 Update. Circulation. 2012 Jan 3;125:e2-e220.

6. Kavo AE, Rallidis LS, Sakellaropoulos GC, Lehr S, Hartwig S, Eckel J, et al. Qualitative characteristics of HDL in young patients of an acute myocardial infarction. Atherosclerosis J. 2012;220(1):257-61.

7. Hbejan K. Smoking effect on Ischemic Heart Disease in young patients. Heart Views. 2011;12:1-6.

8. Isordia I, Leaños A, Sainz I, Reyes E. Asociación entre el polimorfismo 4G/5G en el gen del inhibidor del activador del plasminógeno-1 (PAI-1) y el infarto agudo del miocardio con elevación del ST en pacientes jóvenes. Rev Esp Cardiol. 2009;62(4):365-72.

9. Lee YH, Yang HM, Tahk SJ, Hong YS, Park JS, Seo KW, et al. Recurrent stent thrombosis in a patient with antiphospholipid syndrome and dual anti-platelet therapy non-responsiveness. Korean Circ J. 2015 Jan;45(1):71-6.

10. Rupa-Matysek J, Gil L, Wojtasinska E, Ciepluch K, Lewandowska M, Komarnicki M. The relationship between mean platelet volume and thrombosis recurrence in patients diagnosed with antiphospholipid syndrome. Rheumatol Int. 2014;34(11):1599-605.

11. Mir A, Obafemi A, Young A, Kane C. Myocardial infarction associated with use of the synthetic cannabinoid K2. Pediatrics. 2011;128(6):622-7.

12. Winckers K, Siegerink B, Duckers C, Maurissen LF, Tans G, Castoldi E, et al. Increased tissue factor pathway inhibitor activity is associated with myocardial infarction in young women: results from the RATIO study. J Thromb Haemost. 2011;9(11):2243-50.

13. Möhlenkamp S, Hort W, Ge J, Raimund E. Update on myocardial bridging. Circulation. 2002;106(20):2616-22.

14. Graidis C, Dimitriadis D, Karasavvidis V, Dimitriadis G, Argyropoulou E, Ecnomou F, et al. Percutaneous treatment of spontaneous left main coronary artery dissection using drug-eluting stent. BMC Cardiovasc Disord. 2014;14.

15. Shazad K, Cao L, Ain QT, Waddy J, Khan N, Nekkanti R. Pstpartum spontaneous dissection of the first obtuse marginal branch of the left circumflex coronary artery causing acute coronary syndrome: a case report and literature review. J Med Case Rep. 2013;7:82.

16. Rowley AH, Shulman ST. Pathogenesis and management of Kawasaki disease. Expert Rev Anti Infect Ther. 2010 Feb;8(2):197-203.

17. Eleftheriou D, Levin M, Shingadia D, Tulloh R, Klein N, Brogan P. Management of Kawasaki disease. Arch Dis Child. 2014 Jan;99(1):74-83.

18. Sricharan K, Rajesh S, Rashmi D, Meghana HC, Badiger S, Soumya M. Study of acude myocardial infarction in young adults: risk factors, presentation and angiographic findingas. J ClinDiagn Res. 2012;38(53):1920.

19. Al-Saif SM, Al-Habib KF, Ullah A, Hersi A, Al-Faleh H, Alnemer K, et al. Age and its relationship to acute coronary syndromes in the Saudi Project for Assessment of Coronary Events (SPACE) registry. J Saudi Heart Assoc. 2012 Jan;24(1):9-16.

20. Al-Murayeh MA, Al-Masswary AA, Dardir MD, Moselhy MS, Youssef AA. Clinical presentation and short-term outcome of acute coronary syndrome in native young Saudi population. J Saudi Heart Assoc. 2012 Jul;24(3):169-75.

21. Bhatia LC, Naik RH. Clinical profile of acute myocardial infarction in elderly patients. J Cardiovasc Dis Res. 2013 Jun;4(2):107-11.

22. Jamil G, Jamil M, Al-Khazraji H, Haque A, Chedid F, Balasubramanian M, et al. Risk factor assessment of young patients with acute myocardial infarction. Am J Cardiovasc Dis. 2013;3(3):170-4.

23. Badran HM, Elnoamany MF, Khalil TS, Eldin MME. Age-related alteration of risk profile, inflammatory response and angiographic findings in patients with acute coronary syndrome. Clinic Med Cardiol. 2009;3:15-28.

24. Assiri AS. Gender differences in clinical presentation and management of patients with acute coronary syndrome in Southwest of Saudi Arabia. J Saudi Heart Assoc. 2011;23(3):135-41.

25. Hosseini SK, Soleimani A, Salarifar M, Pourhoseini H, Nematipoor E, Abassi SH, et al. Demographics and angiographics findings in patients under 35 years of age with acute ST elevation myocardial infarction. J Teheran Heart Cent. 2011;6(2):62-7.

26. Montalescot G, Crea F. The year in cardiology 2015: acute coronarysyndromes. Eur Heart J [serial on the Internet]. 2016 Jan 3 [cited 2016 Jan 18]; [about 8 p.]. Available from: http://eurheartj.oxfordjournals.org/

27. Panduranga P, Sulaiman K, Al-Zakwani I, Abdelrahman S. Acute coronary syndrome in young adults from Oman: results from de Gulf Registry of acute coronary events. Heart Views. 2010 Oct-Dec;11(23):93-8.

28. Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome: a burden of the young and poor. Cir Res. 2014 Jun 6;114(12):1959-75.

29. López Ferrero LH. Glosario de hemodinámica y cardiología intervencionista. La Habana: Editorial Científico-Técnica; 2006.

30. O`Gara P, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. J Am Coll Cardiol. 2013 Jan 29;61(4):e78-140.

31. Peterson ED, Dai D, De Long ER, Brennan JM, Singh M, Rao SV, et al. Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the national cardiovascular data registry. J Am Coll Cardiol. 2010 May 4;55(18):1923-32.

32. Harold JG, Bass TA, Bashore TM, Brindis RG, Brush JEJ, Burke JA, et al. ACCF/AHA/SCAI 2013 update of the clinical competence statement on coronary artery interventional procedures. J Am Coll Cardiol. 2013;62:357-96.