First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents
Authors' conclusion
First MI patients with premature CAD, treated with contemporary stents, showed lower rates of MACE and all-cause mortality than patients with non-premature CAD, which is most likely related to differences in cardiovascular risk profile.
Study context
- Population
- Patients with a first myocardial infarction (MI) and no previous coronary revascularization, treated with PCI using new-generation drug-eluting stents
- Participants
- 3,323 patients4 pooled DES trials
- Comparison
- Premature coronary artery disease (CAD) vs non-premature CAD
- Premature CADn = 582
- Outcome
- Major adverse cardiac events (MACE):
- All-cause mortality
- Any MI
- Emergent CABG
- Clinically indicated target lesion revascularization
Methodological details4 large-scale DES trials (TWENTE I–IV)
- 4 large-scale DES trials (TWENTE I–IV)
Pooled result
As reported in the abstract
MACE
Premature CAD vs Non-premature CADEstimate (95% CI)P value
30 days
HR 0.22(0.07–0.71)
P = 0.0051 year
adjusted HR 0.50(0.26–0.96)
P = 0.037Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| MI · 30 days | HR 0.22 (95% CI 0.05–0.89) | P = 0.020 | |
| Target vessel failure · 30 days | HR 0.30 (95% CI 0.11–0.82) | P = 0.012 | |
| All-cause mortality · 1 year | adjusted HR 0.24 (95% CI 0.06–0.98) | P = 0.046 | |
| Mortality · 2 years | adjusted HR 0.16 (95% CI 0.05–0.50) | P = 0.002 | |
| 0.050.21520Ratio (log scale) |
Original publication
First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents. Eur Heart J Acute Cardiovasc Care. Published 24 August 2023. doi:10.
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