1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China; ; 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China;
3. Fine Arts School of Shandong University, Jinan, Shandong 250012, China.
Int J Med Sci. 2014 May 10;11(7):721-5. doi: 10.7150/ijms.8718. eCollection 2014.
We lack data on the long-term outcome of drug-eluting stenting in patients with early-onset coronary artery disease (CAD). Here, we investigated the association of traditional risk factors and major adverse cardiovascular events (MACEs) after drug-eluting stenting in patients with CAD who were < 50 years old.
We enrolled 437 consecutive CAD patients < 50 years old who underwent drug-eluting stenting and 132 subjects who were age- and sex-matched and angiographically shown to be disease free as controls. MACEs were analyzed in CAD patients for a median of 24 months [interquartile range 14-34 months].
Male patients accounted for 90.4% of cases. As compared with controls, patients with early-onset CAD had higher body mass index and rates of smoking, family history of CAD, and diabetes and hypercholesterolemia. During the hospital stay, 1 patient died, and the incidence of MACEs was 1.1%. At the end of follow-up, the overall death rate was 0.7%. MACEs were observed in 54 patients (12.4%). On Cox proportional hazard analyses, positive family history and diabetes were independent risk factors of MACEs (HR 2.61, 95% confidence interval 1.29-4.00, p = 0.002; and HR 2.48, 95% confidence interval 0.86-3.14, p = 0.004, respectively).
Drug-eluting stenting is a reliable treatment for patients with early-onset CAD. Positive family history of CAD and diabetes are independent risk factors of adverse cardiovascular events in this subgroup of patients after drug-eluting stent implantation.
我们缺乏关于早发冠心病（CAD）患者药物洗脱支架置入后长期结局的数据。在此，我们研究了＜50 岁 CAD 患者药物洗脱支架置入后传统危险因素与主要不良心血管事件（MACE）的相关性。
我们纳入了 437 例连续的＜50 岁 CAD 患者行药物洗脱支架置入，并纳入 132 例年龄和性别匹配且血管造影显示无疾病的患者作为对照。CAD 患者的 MACE 进行了中位数为 24 个月（14-34 个月）的中位随访。
男性患者占 90.4%。与对照组相比，早发 CAD 患者的体重指数更高，且吸烟、CAD 家族史、糖尿病和高胆固醇血症的发生率更高。住院期间，1 例患者死亡，MACE 发生率为 1.1%。随访结束时，总死亡率为 0.7%。54 例患者（12.4%）观察到 MACE。Cox 比例风险分析显示，阳性 CAD 家族史和糖尿病是 MACE 的独立危险因素（HR 2.61，95%置信区间 1.29-4.00，p=0.002；和 HR 2.48，95%置信区间 0.86-3.14，p=0.004）。
药物洗脱支架置入术是治疗早发 CAD 患者的可靠方法。CAD 阳性家族史和糖尿病是该亚组患者药物洗脱支架置入后不良心血管事件的独立危险因素。
