ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Percutaneous Coronary Intervention in Patients Aged ≤40 Years: A 10-Year Single-Center Cohort Study
Lining Liang
Chunsong Wang
Huawei Dong
Liaocheng People's Hospital, Liaocheng, China
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Abstract
Background: Coronary artery disease (CAD) in adults ≤40 years is increasing, yet long-term outcomes after percutaneous coronary intervention (PCI) in the drug-eluting stent (DES) era remain unclear. We aimed to identify procedural patterns and prognostic factors in this very young cohort. Methods: This single-center retrospective cohort study included 312 consecutive patients aged ≤40 years who underwent successful PCI for de novo lesions (≥70% stenosis) between 2014-2024. Baseline characteristics, quantitative coronary angiography, and procedural data were collected. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Cox regression identified independent predictors. Results: Patients were 82% male (mean age 36.8±4.9 years) with median SYNTAX score 16. Procedural success was 98.4% with 93.9% DES implantation and 85.9% radial access. Over 1,620 patient-years (median 5.2 years), MACCE occurred at 27.8 per 1,000 patient-years (5-year cumulative 14.2%). Cardiac mortality was 3.7 per 1,000 patient-years. Diabetes (adjusted HR 1.78, 95% CI 1.06-2.99), SYNTAX ≥23 (HR 2.01, 1.19-3.40), and DAPT <12 months (HR 1.62, 1.00-2.64) independently predicted MACCE. Conclusions: Young adults undergoing PCI exhibit complex anatomy but low cardiac mortality. Diabetes, angiographic complexity, and abbreviated antiplatelet therapy drive adverse events, warranting intensive prevention and optimized antiplatelet strategies.
Summary
Keywords
Coronary intervention, Drug-eluting stent, percutaneous, Premature coronary artery disease, Syntax score, Young Adult
Received
05 December 2025
Accepted
06 February 2026
Copyright
© 2026 Liang, Wang and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Lining Liang
Disclaimer
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