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Clinical characteristics, in-hospital and long-term outcomes of stable angina treatment in patients below and over 40 years of age (from the PRESAGE registry).

Clinical characteristics, in-hospital and long-term outcomes of stable angina treatment in patients below and over 40 years of age (from the PRESAGE registry).
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Trzeciak P, Desperak P, Ciślak A, Hawranek M, Gąsior M,


Trzeciak P, Desperak P, Ciślak A, Hawranek M, Gąsior M, (click to view)

Trzeciak P, Desperak P, Ciślak A, Hawranek M, Gąsior M,

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Kardiologia polska 2017 11 23() doi 10.5603/KP.a2017.0200
Abstract
BACKGROUND
There is a paucity of data concerning young patients with stable angina (SA).

AIM
The study was aimed to compare the characteristics, as well as in-hospital one, two, and five year outcomes of patients aged ≤40 and >40 years with stable angina.

METHODS
The analysis involved 80 patients aged ≤40 years and 9,299 patients aged >40 years with SA treated in the 3rd Department of Cardiology in Zabrze between 2006 and 2014, and enrolled in the ongoing PRESAGE Registry. Propensity scores matching was used to adjust for differences in patients’ baseline characteristics. The composite endpoint involved death, non-fatal MI, and acute coronary syndrome or ACS-driven unplanned revascularization within one, two, and five year observation period.

RESULTS
In comparison to older patients, the younger ones had a higher incidence of smoking (58.3% vs 35.2%, p<0.0001) and previous percutaneous angioplasty (45% vs 33.7%, p=0.033). There was no significant difference in in-hospital outcomes. The composite endpoint incidence did not differ significantly between the young and old group within one year (1.3% vs 8.1%, p=0.068), two years (5.8% vs 12.9%, p=0.08), and five years (23.1% vs 25.7%, p=0.71) after discharge. Young patients had a borderline lower mortality rate (0% vs 4.5%, p=0.053) after a one-year follow-up and a significantly lower mortality rate within two and five years after index hospitalization (0% vs 7.8%, p=0.02 and 5.1% vs 17.1%, p=0.04, respectively). After propensity score matching analysis, a significantly lower 2-year mortality was observed in the ≤40 age group (0% vs 8.1%; p=0.016), without significant difference in 5-year follow-up (5.1% vs 13.5%; p = 0.21). CONCLUSIONS
The younger and older group of patients with SA differed in clinical characteristics, with no significant difference in the in-hospital outcomes and composite endpoint incidence in the follow-up period. However, younger patients had a borderline lower mortality rate one year after discharge and a significantly lower mortality rate two and five years after index hospitalization.

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