<![CDATA[Background: Premature coronary artery disease (PCAD) is increasingly recognised in Asian percutaneous coronary intervention (PCI) practice, yet baseline predictors of major adverse cardiovascular events (MACE) after revascularisation remain poorly characterised.Objective: To identify independent baseline predictors of MACE after PCI in PCAD and determine whether a stricter "Asia Pacific" age band discriminates risk within the premature range.Methods: Retrospective cohort study at a tertiary PCI centre in Malang, Indonesia (January 2022–March 2025; follow-up censored 1 May 2026). Patients meeting 2019 ACC/AHA PCAD criteria (men <55 years or women <65 years) with confirmed obstructive coronary artery disease (CAD) treated by PCI were enrolled. The primary outcome was composite MACE (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, heart-failure hospitalisation, or unplanned revascularisation), assessed by cause-specific Cox proportional-hazards regression.Result: Among 318 patients who completed follow-up (median age 50 years; 31.4% women; median follow-up 930.5 days), 41 MACE events occurred (12.9%). MACE incidence was similar between Asia Pacific PCAD (n=159; 11.3%) and Older PCAD (n=159; 14.5%; 3-year cumulative incidence 12.0% vs 16.9%; log-rank p=0.308). Reduced left ventricular ejection fraction (LVEF <40%) and dyslipidaemia were independent baseline predictors (LVEF <40%: adjusted HR 1.79, 95% CI 1.09–2.95; dyslipidaemia: adjusted HR 3.84, 95% CI 2.09–7.07; C=0.717, bootstrap-corrected C=0.715 (1000 resamples; optimism +0.002)).Conclusion: Reduced LVEF and dyslipidaemia were the principal baseline predictors of MACE in this Indonesian single-centre PCAD post-PCI cohort; age stratification within the premature range did not discriminate risk. Results should be interpreted in the context of 29.3% loss to follow-up and single-centre design.]]>
