Objective: This study is designed to systematically assess the safety and efficacy profiles associated with varying procedural sequences of endovascular aortic repair (EVAR) and percutaneous coronary intervention (PCI) in clinical practice. Methods: We conducted a retrospective cohort analysis encompassing patients diagnosed with aortic aneurysm and concomitant coronary artery disease (CAD) who underwent EVAR at Beijing Anzhen Hospital, Capital Medical University, between January 2010 and December 2022, with planned staged (preoperative or postoperative) or simultaneous PCI. The cohort was stratified into three groups: PCI followed by EVAR, EVAR followed by PCI, and simultaneous EVAR and PCI. The primary endpoint was a composite of all-cause mortality, non-fatal myocardial infarction, cerebrovascular events, and aortic-related complications within 12 months post-intervention. Secondary endpoints included duration of hospital stay, total hospitalization costs, and incidence of in-hospital adverse events. Multivariate logistic regression analysis was employed to identify independent predictors of the primary endpoint. Results: The study cohort comprised 374 patients, with 209 (55.9%) undergoing PCI followed by EVAR, 133 (35.6%) receiving EVAR followed by PCI, and 32 (8.5%) undergoing simultaneous EVAR and PCI. Comparative analysis revealed no statistically significant differences in the incidence of in-hospital adverse events (p = 0.867) or the risk of primary endpoint events (p = 0.645) across the three treatment groups. Notably, the simultaneous treatment group demonstrated a significantly reduced total hospital stay (10.6 days) compared to the PCI followed by EVAR group (16.0 days) and the EVAR followed by PCI group (17.2 days) (p < 0.001), accompanied by lower hospitalization costs (p = 0.002). Conclusions: For patients with aortic aneurysm complicated by CAD requiring both EVAR and PCI, simultaneous intervention appears to be a safe and feasible therapeutic option. This approach significantly reduces hospital stay duration and associated costs without increasing the risk of in-hospital adverse events or compromising 12-month postoperative outcomes. However, this exploratory finding requires validation in large-scale randomized controlled trials.

Background: Premature acute myocardial infarction (AMI) has become an important public health challenge. Young survivors face prolonged residual cardiovascular risk, yet real-world implementation of long-term secondary prevention across medication use, health behaviors, and risk-factor monitoring remains insufficiently characterized in China. Methods: In this hospital-based cross-sectional study, we included 1377 young AMI survivors aged 18–44 years who attended follow-up at Beijing Anzhen Hospital between 2023 and 2025. Current use of major secondary prevention medications, achievement of four health-behavior targets (smoking abstinence/cessation, physical activity, diet, and sleep), and lipid monitoring during the preceding 12 months were assessed using standardized interviews and medical records. Recurrent myocardial infarction (MI) and repeat coronary revascularization occurring between discharge after the index AMI and the study visit were retrospectively identified. Multivariable logistic regression was used to examine associations between secondary-prevention implementation domains and recurrent events. Results: Participants had a mean age of 39.1 years, and 95.9% were male. Recurrent MI occurred in 9.2% and repeat revascularization in 13.7%. The proportion concurrently using four major medication classes decreased from 50.0% at discharge to 25.9% at follow-up. Overall, 45.1% achieved good behavioral implementation, defined as meeting at least three of four ideal behaviors. In fully adjusted models, good behavioral implementation was associated with lower odds of recurrent MI (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.32–0.73) and repeat revascularization (OR 0.72, 95% CI 0.52–1.00). Concurrent use of all four medication classes and frequent lipid monitoring were not independently associated with recurrent outcomes. Conclusions: Among young AMI survivors in China, substantial gaps in long-term secondary prevention were observed, particularly for healthy behaviors. These findings support the public health importance of strengthening lifestyle-oriented and multidisciplinary follow-up strategies for young survivors of AMI. Because exposure and outcome periods overlapped partially, findings should be interpreted as associational rather than causal.

Patients undergoing percutaneous coronary intervention (PCI) require long-term antiplatelet therapy to prevent thrombotic events. However, those at high bl