Clinical characteristics, and in-hospital and long-term outcomes of stable angina treatment in patients below and over 40 years of age (from the PRESAGE registry)

Abstract

Background: There is a paucity of data concerning young patients with stable angina (SA). Aim: The study aimed to compare the characteristics, as well as in-hospital one-, two-, and five-year outcomes of patients aged ≤ 40 and > 40 years with SA. Methods: The analysis involved 80 patients aged ≤ 40 years and 9299 patients aged > 40 years with SA treated in the 3rd Department of Cardiology in Zabrze between 2006 and 2014, and enrolled in the ongoing PRESAGE Registry. Propensity scores matching was used to adjust for differences in patients’ baseline characteristics. The composite endpoint involved death, non-fatal myocardial infarction, and acute coronary syndrome (ACS) or ACS-driven unplanned revascularisation within one-, two-, and five-year follow-up periods. Results: In comparison to older patients, the younger ones had a higher incidence of smoking (58.3% vs. 35.2%, p < 0.0001) and previous percutaneous angioplasty (45% vs. 33.7%, p = 0.033). There was no significant difference in in-hospital outcomes. The composite endpoint incidence did not differ significantly between the young and old group within one year (1.3% vs. 8.1%, p = 0.068), two years (5.8% vs. 12.9%, p = 0.08), and five years (23.1% vs. 25.7%, p = 0.71) after discharge. Young patients had a borderline lower mortality rate (0% vs. 4.5%, p = 0.053) after a one-year follow-up and a significantly lower mortality rate within two and five years after index hospitalisation (0% vs. 7.8%, p = 0.02 and 5.1% vs. 17.1%, p = 0.04, respectively). After propensity score matching analysis, a significantly lower two-year mortality was observed in the ≤ 40 age group (0% vs. 8.1%; p = 0.016), without significant difference during five-year follow-up (5.1% vs. 13.5%; p = 0.21). Conclusions: The younger and older groups of patients with SA differed in clinical characteristics, with no significant difference in the in-hospital outcomes and composite endpoint incidence in the follow-up period. However, younger patients had a borderline lower mortality rate one year after discharge and a significantly lower mortality rate two and five years after the index hospitalisation.