冠状动脉经皮介入术治疗高龄非ST段抬高型急性冠脉综合征的疗效

目的 评价经皮冠状动脉介入（PCI）治疗在高龄（>80岁）非ST段抬高型急性冠脉综合征(NSTE-ACS)中的安全性和有效性。方法 经冠状动脉造影检查证实冠脉狭窄程度在70%~90%的NSTE-ACS患者175例，根据是否介入治疗分为，介入组84例（发病后3~7 d接受择期PCI），药物组91例（未行PCI术，单纯优化药物治疗）。观察记录两组患者临床特征、1年随访期间主要心血管不良事件。结果 介入组与药物组相比，介入组能显著降低心因住院、血运重建、心绞痛复发风险，在全因死亡、脑梗死、严重的出血事件方面差异无统计学意义。结论 对于高龄NSTE-ACS患者接受PCI术是安全、有效的。

Curative effect of percutaneous coronary intervention in patients aged over 80 years with non-ST-segment elevation acute coronary syndrome

AIM To evaluate the safety and efficacy of percutaneous coronary intervention (PCI) for the treatment of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in patients over 80 years old. METHODS A total of 175 NSTE-ACS patients with confirmed coronary artery stenosis 70%-90% by coronary angiography were divided into a PCI group and an optimal drug therapy group. Patients in the PCI group underwent PCI 3-7 days after the onset of NSTE-ACS and those in the optimal drug therapy group received only optimal drug treatment. The clinical characteristics of the two groups were observed and major adverse cardiac events during the 1-year follow-up were recorded. RESULTS When compared with those in the optimal drug therapy group, the risk of re-admission for cardiac problems, urgent revascularization, and incidences of recurrent angina in the PCI group were significantly decreased. There were no statistical difference in all-cause mortality, stroke, and major bleeding between the PCI and optimal drug therapy groups. CONCLUSION PCI technique is safe and effective for the treatment of NSTE-ACS in patients over 80 years.