Short-term follow-up results of drug-eluting stenting in premature coronary artery disease patients with multiple atherosclerotic risk factors.

Background: Premature coronary artery disease (CAD) is a special entity with a strong link to familial hypercholesterolemia, family history of premature CAD, or multiple coexistent atherosclerotic risk factors. Drug-eluting stenting (DES), including paclitaxel-eluting stenting (PES) and sirolimus-eluting stenting (SES), has been proven to have a lower restenotic rate. However, to date, few studies have investigated the clinical and angiographic results of DES in premature CAD patients.

Methods: Between February 2004 and October 2005, premature CAD patients, defined as those younger than 50 years of age, who were treated with DES in our medical center were all retrospectively enrolled. Their baseline clinical characteristics, clinical outcome and angiographic follow-up results were analyzed.

Results: A total of 26 patients (M/F: 23/3) were enrolled, with a mean age of 44+/-6 years (range, 24-50 years). Conventional atherosclerotic risk factors were prevalent in this study group, including diabetes mellitus (35%), hypertension (35%), hyperlipidemia (54%) and smoking (73%). Moreover, there was 1 homozygous and 1 heterozygous familial hypercholesterolemia case in our study group. In terms of angiographic results, there were 40 target lesions in 34 target vessels. Forty DES (39 PES, 1 SES) were implanted with a median stent diameter of 3 mm and median length of 24 mm. The clinical follow-up was counted up to May 2006, with a mean follow-up duration of 540+/-168 days; 11 (42%) patients had a second angiogram during the follow-up period (200+/-98 days after DES). None of the patients had target lesion revascularization (TLR). In addition, there was no difference in TLR or stent thrombosis between patients with or without acute coronary syndrome.

Conclusion: Based on our single-center experience, DES had good short-term follow-up results for a premature CAD group with diverse and multiple atherosclerotic risk factors.