CORONARY ANGIOPLASTY IN THE YOUNG - PROCEDURAL RESULTS AND LATE OUTCOME

Procedural outcome of coronary angioplasty in 89 patients less-than-or e-qual-to 40 years was compared to an older group of 1,916 patients > 40 years. Young patients were more often male (98% vs. 81%), smokers ( 89% vs. 70%), and more stressed (subjectively) (29% vs. 15%) compared to the older group. Other coronary risk factors were less common in th e younger group: diabetes (5% vs. 13%), and hypertension (19% vs. 40%) . Left ventricular function, number of diseased vessels, and the numbe r and location of sites dilated were similar in the two groups. Proced ural success rates were similar in the two groups (90% in young, 86% i n old; p=NS). Younger patients suffered no major complications of the procedure, in contrast to a myocardial infarction rate of 5%, and urge nt bypass surgery and mortality rates of 1% each in the older group. Y oung patients were followed up for a mean of 30 +/- 26 months after th e procedure, with an actuarial 5-year survival of 100%. Four patients (5%) required elective coronary bypass surgery: two due to a failed an gioplasty attempt (failure to cross), the other two for progressive mu ltivessel disease. A total of 28 patients (34%) required re-angioplast y (restenosis: 13%, progression elsewhere: 12% , both: 9%). All re-ang ioplasty procedures were angiographically and clinically successful, w ith no major complications. For young patients, coronary angioplasty i s a safe and effective procedure. If technically feasible, angioplasty should be considered the initial therapeutic option without neglectin g risk factor modification.