Desenlaces cardiovasculares adversos mayores en pacientes con síndrome coronario agudo temprano

Introduction and objective: Coronary disease has become one of the main causes of death in individuals less than 55 years-old in the last 20-30 years or so. This has led to the need to increase the knowledge in this growing population, as well as its characteristics, risk factors and eventual clinical outcomes. Methods: A cohort study was conducted in order to evaluate the effect of the cardiovascular risk factors, as well as the clinical and coronary angiography variables on the incidence of a major adverse cardiovascular outcome, in patients with a first acute coronary event before 55 years-old. Correlations were performed between the variables and the time free from a major adverse cardiovascular outcome. Results: The study included 193 patients, with a mean follow-up of 1.7 years per patient. The median age was 51 years. An association was found between the type of coronary event, acute myocardial infarction with ST elevation (RR=8.4, 95% CI; 1.9-37.4) and a Killip score > II (RR 5.57, 95% CI; 1.2 – 25.2), with a greater number of in-hospital complications. Those with circumflex artery involvement (RR=4.5, 95%CI; 1.65 – 12.4) and a requirement for three or more coronary stent implants (RR 4.7, 95%CI; 1.7-12.7), had a higher risk of suffering a new cardiovascular event. Conclusion: Patients less than 55 years-old with acute coronary syndrome and circumflex artery involvement, or the requirement of the implanting more than three stents, have a higher number of adverse cardiovascular outcomes.