Coronary Artery Disease in Young Adults: Who Needs Surgical Revascularization? A Retrospective Cohort Study

Authors

  • Jacek PiÄ…tek Institute of Cardiology and Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow
  • Anna KÄ™dziora Cardiosurgical Students’ Scientific Group, Jagiellonian University Medical College, Krakow
  • Janusz Konstanty-Kalandyk Institute of Cardiology and Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow
  • Grzegorz Kiełbasa University Hospital, Jagiellonian University Medical College, Krakow
  • Marta Olszewska Cardiosurgical Students’ Scientific Group, Jagiellonian University Medical College, Krakow
  • Karol Wierzbicki Institute of Cardiology and Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow
  • Irena Milaniak Institute of Cardiology and Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow
  • Bryan HyoChan Song Cardiosurgical Students’ Scientific Group, Jagiellonian University Medical College, Krakow
  • Bogusław Kapelak Institute of Cardiology and Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow
  • Tomasz Darocha Department of Anesthesiology and Intensive Care, Jagiellonian University Medical College, John Paul II Hospital, Krakow

DOI:

https://doi.org/10.1532/hsf.1552

Abstract

Background: Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Despite the fact that prevalence accrues with age, an increasing number of young patients suffering from CAD is being observed worldwide. The aim of this study is to describe the population of young adults suffering from CAD and requiring coronary artery bypass grafting (CABG), and to assess early outcomes after the procedure.
Methods: A retrospective cohort study analyzed 190 consecutive patients aged ≤50 years old that underwent CABG between 2010 and 2014. Baseline characteristics and operative data were presented in the study. Postoperative complications, such as major adverse cardiac and cardiovascular events (MACCE), prolonged mechanical ventilation (>72 hours), bleeding requiring reexploration, sternal dehiscence, and others were assessed.
Results: A population comprising mostly overweight or obese males with a mean age of 46 ± 4.1 years was analyzed. Patients suffered mostly from three-vessel disease (81%), hypertension (74.7%), and had previous history of myocardial infarction (MI) (60%). The majority of patients had normal left ventricle ejection fraction (LVEF) (83.1%). 22.6% of cases were emergent procedures. Perioperative mortality was low (1%) and overall MACCE rate stood at 2.6%. Emergent surgery was associated with a higher incidence of postoperative complications (P = .007). The number of diseased vessels, LVEF, and CCS/NYHA class-on-admission was not associated with a higher incidence of postoperative complications (P > .05 for all).
Conclusion: CAD in young patients remains an issue described insufficiently in the literature. Among our study cohort of younger patients undergoing CABG, the majority of the patients had multivessel disease and were slightly symptomatic with normal LVEF. Although the postoperative complication rate was low, the percentage of emergent surgeries was alarmingly high in this population. Consistent with the literature, we highlight the importance of CAD screening in the young population to detect subclinical disease, which might be treated therapeutically or operated electively.

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Published

2016-08-22

How to Cite

PiÄ…tek, J., KÄ™dziora, A., Konstanty-Kalandyk, J., Kiełbasa, G., Olszewska, M., Wierzbicki, K., Milaniak, I., Song, B. H., Kapelak, B., & Darocha, T. (2016). Coronary Artery Disease in Young Adults: Who Needs Surgical Revascularization? A Retrospective Cohort Study. The Heart Surgery Forum, 19(4), E170-E174. https://doi.org/10.1532/hsf.1552

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