老年人冠状动脉裸金属支架植入术后冠脉造影及临床随访观察

目的观察老年人冠脉裸金属支架(bare metal stent,BMS)术后冠脉造影随访结果及临床事件。方法冠心病患者在成功冠脉内裸金属支架术后患者进行冠状动脉造影随访复查,根据患者年龄分为≥60岁的老年组及<60岁的非老年组,对两组支架植入术后冠脉造影随访资料及临床资料进行对比分析。结果老年组89名患者共植入121个裸金属支架,非老年组53例患者植入71个。两组在病变类型、狭窄程度、残余狭窄、支架长度、直径间差异无统计学意义。随访期间老年组与非老年组分别有心力衰竭10例(11.2%)与1例(1.9%)(P<0.05)。冠脉造影发现,两组分别有47个及24个支架发生支架内再狭窄,分别为38.8%及33.8%(P>0.05),再狭窄类型在两组间差异无统计学意义。老年组及非老年组中有新病变或病变进展者非别为22例(24.7)%及23例(43.4%)(P<0.05)。结论老年人成功冠脉裸金属支架植入术后,冠脉造影随访发现支架内再狭窄发生率与非老年人相似,但发生心力衰竭者明显高于非老年人。

The angiographic characteristics and clinical events after coronary bare metal stent implantation in elderly patients

Objective To observe angiographic characteristics and clinical events of post coronary bare metal stent（BMS） implantation in the elderly patients. Methods The patients with coronary bare metal stent implantation were followed up clinically and by angiography. The patients were divided into two groups of age ≥60 years as elderly group and age 〈 60 years of non-elderly group and the their clinical events and angiographic characteristics were retrospectively analyzed. Results 121 bare metal stents were implanted in 89 elderly patients and 71 stents implanted in 53 non-elderly patients. There was no significantly difference in coronary lesion types, degree of stenosis, stent length,stent diameter and residual stenosis between the two groups. There were more patients with heart failure in elderly group than that in non-elderly group（ 11.2% vs 1.9%, P 〈 0. 05）. The in-stent restenosis rate defined by coronary angiography were 38.8% in elderly group and 33.8% in non-elderly group, the difference was not statistically significant （P 〉 0. 05）. The types of in-stent restenosis were not significantly different between the groups. There were significantly less patients with new lesion or lesion progression in the elderly group than that in non-elderly group（24.3% vs 43.4% ,P 〈0. 05）. Conclusion The in-stent restenosis rate in the elderly is comparable to the non-elderly patients, but the elderly patients have more frequency occurrence of heart failure.