RESULTS OF PERCUTANEOUS CORONARY ANGIOPLASTY IN PATIENTS LESS-THAN-40YEARS OF AGE

This study examined factors influencing the outcome of percutaneous tr ansluminal coronary angioplasty (PTCA) in patients less-than 40 years of age. We followed 86 patients (mean age 37 years) treated from 1982 to 1994. The primary procedural success was 90%. At follow-up of 83 pa tients (97%) at a mean of 48 +/- 33 months (range 5 to 147), there had been 3 late deaths. Actuarial survival at 5 and 10 years was 95% and 91%, respectively. At review only 5% of patients had class III angina and no patient had class IV angina. Repeat revascularization (PTCA alo ne in 21 [25%], surgery in 8 [10%], or both in 10 [12%] patients) was performed for restenosis in 29 patients (35%) and for disease progress ion at other sites in 10 patients (12%). On multivariate analysis, a h istory of diabetes mellitus (p less-than 0.02) was the only factor ass ociated with death or a subsequent cardiovascular event (myocardial in farction, stroke, or hospital admission with unstable angina). At foll ow-up, 20 patients (24%) still smoked, 64 (77%) had a total cholestero l level greater-than-or-equal-to 200 mg/dl, 20 (24%) had a body mass i ndex greater-than-or-equal-to 30, and 15 (18%) were not taking aspirin . In conclusion, PTCA in adults less-than 40 years of age has excellen t early results with a low morbidity and mortality. The medium-term pr ognosis and control of symptoms was good, although by 5 years, further revascularization was required in almost half of the patients. (C) 19 98 by Excerpta Medica, Inc.