不完全血运重建策略对老年冠状动脉多支血管病变患者预后的影响

目的回顾性分析经皮冠状动脉介入的完全及部分血运重建术对老龄冠状动脉多支血管病变患者预后影响、疗效。方法 153例年龄≥70岁的老年患者,2005年10月至2008年3月入院行冠状动脉造影检查发现为多支病变行经皮冠状动脉介入(PCI)治疗。分为接受经皮冠状动脉介入治疗的完全血运重建(85例)组和接受介入治疗的部分血运重建患者(68例)。记录分析两组患者临床资料、PCI结果以及围术期并发症和随访期间主要不良心脏事件(MACE)、死亡率发生情况。进行Cox回归分析影响此类患者预后的相关因素。结果老年冠心病多支病变患者PCI进行血运重建完全者与血运重建不完全者的院内围手术期及随访1年后的死亡、急性心肌梗死、总心脏死亡率等MACE的发生率差异无统计学意义。Cox多因素回归分析表明患者PCI术后1年MACE发生率与是否完全血运重建无关(HR1.328,95%CI0.253～2.652,P>0.05)。结论介入治疗完全血运重建与不完全血运重建策略对老年冠状动脉多支病变的1年临床效果相似。

Effect of incomplete revascularization strategy by percutaneous coronary intervention on the outcome and prognosis in aged patients with multivessel coronary artery disease

Objective To evaluate the influence of incomplete revascularization strategy by percutaneous coronary intervention(PCI) on efficiency and prognosis for aged patients with multivessel coronary artery disease.Methods The study retrospectively analysed the clinical data of 153 aged patients(age between 70 to 85 years old) with multivessel coronary artery diease complicated with cardiac insufficiency,who underwent PCI procedure between October 2005 to March 2008 in our hospital.These patients were divided into two groups according to complete(n=85) or incomplete(n=68) revascularization they had received.The mortality rate,MACE,total cardiovascular mortality rate during hospitalization and follow-up were studied.Cox multivariant regression analysis was used to analysis the risk factor for prognosis.Results The mortality during hospitalization total mortality rate and incidence of MACE during 12 mongths follow-up showed no differences between the two groups.Cox multivariant regression analysis indicated that complete coronary revascularization was irrelevant to prognosis in aged patients with multivessel coronary artery diease(HR 1.328,95%CI 0.253-2.652,P>0.05).Conclusion The efficiency and prognosis of incomplete revascularization by PCI in older patients with multivessel coronary disease was similar to complete revascularization at 1 year after PCI.