药物洗脱支架植入治疗早发冠心病的近期临床随访研究

目的研究接受药物洗脱支架治疗的早发冠心病(PCAD)患者近期预后。方法收集290例PCAD患者(男<55岁,女<65岁)和227例非冠心病对照者临床资料,对PCAD中行药物洗脱支架(西罗莫司或紫杉醇洗脱支架)植入治疗的180例患者(单支病变组62例及多支病变组118例)进行6个月随访研究。结果 PCAD组男性、高血压、糖尿病、吸烟、肥胖及饮酒比例及总胆醇、低密度脂蛋白胆固醇、载脂蛋白B、脂蛋白(a)及空腹血糖水平均高于非冠心病对照组(P均<0.05)。药物洗脱支架治疗多支病变组糖尿病比例高于单支病变组(P<0.01)。接受药物洗脱支架治疗的PCAD单支病变组及多支病变组术后6个月单一及复合心血管事件差异无统计学意义(P>0.05)。结论 PCAD患者临床心血管危险因素多,接受药物洗脱支架治疗后的近期预后较好。

Clinical follow-up of patients with premature coronary artery disease undergoing intervention with drug-eluting stents

Objective To investigate the clinical characteristics,short-term outcomes in patients with premature coronary disease （PCAD） undergoing coronary intervention with drug-eluting stents （DESs）. Methods The baseline clinical and coronary angiographic data of 517 patients （female 65 years,male55 years） undergoing coronary angiography （CAG） were collected and analyzed. Patients were divided into PCAD group （n=290） and non-CAD group （n=227）. 180 patients with PCAD implanted with DESs （sirolimus-eluting stents or paclitaxel-eluting stents） were assessed for the single and cumulative incidence of major adverse cardiac events （MACEs） during half-year follow-up. Results Patients with PCAD had significantly higher rate of male,hypertension,diabetic mellitus,smoking,drinking and obesity,higher levels of TC,LDL-C,apo B and Lp （a） than that in non-CAD group （all P0.05）. There is higher ratio of diabetic mellitus in the multiple branch lesions group than in single branch lesion group （P0.01）. Both patients implanted with DESs in multiple branch lesions group and single branch lesion group had similar half-year prognosis （P0.05）. Conclusions Patients with PCAD had more cardiovascular risk factors and better half-year prognosis after implanted with DESs.