缺血预适应对老年急性心肌梗死患者经皮冠状动脉介入治疗预后的影响

目的 研究缺血预适应(IP)对接受经皮冠状动脉介入治疗(PCI)的不同年龄急性心肌梗死(AMI)患者保护作用的异同.方法 回顾性分析2006年3月至2010年3月190例首次发生AMI患者的临床资料.所有患者在发病12h内进行PCI,按年龄分为老年组(≥60岁,n=105)及成年组(<60岁,n=85),再依据AMI前...

The effect of ischemic preconditioning on the prognosis of elderly AMI patients with primary percutaneous coronary intervention

Objective To investigate the effect of ischemic preconditioning on different age of acute myocardial infarction patients with primary percutaneous coronary intervention(PCI).Methods Clinical data were collected retrospectively from 190 patients who underwent primary PCI within 12h after the first acute myocardial infarction.All patients were divided into two groups including the elder group(≥ 60 years old,n=105) and the adult group(<60 years old,n=85),and each group was divided into two subgroups:the ischemic preconditioning group(IP subgroup) and non-ischemic preconditioning group(NIP subgroup),based on whether they had angina pectoris attacks within 48h before infarction.The baseline indicators,infarct-related artery(IRA)blood flow,TIMI grade rating,reperfusion arrhythmias,peak concentration of biomarkers(CK,CK-MB,cTNI),left ventricular function and short-term prognosis for each subgroup were analyzed retrospectively.Results In adult group,the IP subgroup’s LVEF was higher than the NIP subgroup’s(63.7±9.8)% vs.(59.1±10.7)%,P = 0.046].The rate of no-reflow of IRA was lower in the IP than the NIP subgroup(0 vs.10.9%,P = 0.034),respectively.The rate of reperfusion arrhythmias was lower in the IP than the NIP subgroup(2.6% vs.15.2%,P = 0.046),respectively.The peak concentration of biomarkers was significantly lower in the IP than in the NIP subgroup.But there was no significant difference between IP and NIP subgroups for the elder group.Conclusions Pre-infarction angina has cardiac protective effect in adult patients with AMI,and improves the prognosis for these patients with PCI,but the ischemic preconditioning effect is lost in the elderly.