Prognostic Factors and Outcomes in Young Chinese Patients With Acute Myocardial Infarction Undergoing Primary Coronary Angioplasty
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概要
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We investigated the prognostic risk and the clinical outcome of young-adult patients with ST-segment elevation (ST-se) acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). Between May 1999 and September 2007, primary PCI was performed in 1680 consecutive patients with AMI of onset < 12 hours (cardiogenic shock within 18 hours) at Kaohsiung Chang Gung Memorial Hospital. Of these patients, 163 (9.7%) young-age patients (defined as male of < 45 years old and female of < 55 years old) were enrolled into this study. A comparable number (n = 175) of patients ≥ 55 years old, who presented with AMI of < 12 hours duration having undergone primary PCI between November 2004 and May 2006, were retrospectively reviewed and enrolled as control subjects. The procedural success (defined as normal blood flow achieved in the infract-related artery) was similar between the young-age and old-age patients (P = 1.0). Additionally, the incidence of an advanced Killip score (defined as ≥ score 3 upon presentation), 30-day and 6-month cumulative mortality did not differ between these two groups of patients (P > 0.1). However, the 30-day major adverse clinical outcome (MACO) (defined as New York Heart Association Functional Classification ≥ 3 or 30-day mortality) was significantly lower in the young-age than in the old-age patients (P < 0.001). Further, multiple stepwise logistic regression analysis showed that an advanced Killip score along with the peak level of CK-MB was independently predictive of 30-day MACO (P < 0.05) in young-age patients. In conclusion, the prognostic outcome is favorable in young-adult ST-se AMI undergoing primary PCI. Traditional risk factors remain effective for stratification of young-adult AMI patients into high- or low-risk subgroups.
- International Heart Journal刊行会の論文
著者
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Chen Yung-Lung
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medi
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Hsieh Yuan-kai
Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica
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Fang Chih-yuan
Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica
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Youssef Ali
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medi
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Bhasin Anuj
Division Of Cardiology Department Of Internal Medicine
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Hang Chi-ling
Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C
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Wu Chiung-jen
Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C
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Yang Cheng-hsu
Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C
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Yip Hon-kan
Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C
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Hang Chi-Ling
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine
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Chen Yung-Lung
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine
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Youssef Ali
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine
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