不同左室射血分数等级冠心病患者接受冠状动脉介入治疗的预后分析

目的:探讨不同心功能状态的冠心病患者接受冠状动脉介入(PCI)治疗的预后情况。方法:连续入选接受PCI治疗的2 234例患者,至少随访1年以上。按照LVEF分为:A组,LVEF≤40%(106例);B组,LVEF 41%～49%(205例);C组,LVEF≥50%(1 923例)。比较各组院内、长期死亡及主要不良心脑血管事件(MACCE)的发生率。结果:A、B、C组院内死亡率分别为2.8%、0.5%、0.2%,P<0.01;长期死亡率分别为5.7%、4.4%、1.6%,P<0.01。A、B、C组院内MACCE率为5.7%、2.0%、1.0%,P<0.01;长期MACCE率为18.8%、11.6%、11.7%,P<0.05。COX多因素回归示:A组患者长期死亡风险是C组患者的3.646倍(RR3.646,95%CI1.517～8.762);B组患者长期死亡风险是C组患者的2.184倍(RR2.184,95%CI 1.321～5.684)。结论:LVEF≤40%患者院内及长期死亡率和MACCE发生率仍明显高于LVEF>41%患者。

Comparison of outcome in patients with percutaneous coronary intervention in different left ventricular ejection fractions

Objective:To investigate short-term and long-term prognosis of the patients with different states of cardiac function after receiving PCI.Method:The study was the retrospective registered study in the single center,including 2 234 patients received PCI.All patients were divided into 3 groups by left ventricular ejection fraction(LVEF): A group, LVEF≤40%(n=106);B group,LVEF 41% to 49%(n=205);C group,LVEF≥50%(n=1 923).The time of follow-up was more than one year.The mortality and the MACCE were compared among 3 groups.Result:The in-hospital mortality in A,B,C group were 2.8%,0.5%,0.2%,respectively,P<0.01.The long-term mortality in A,B, C group were 5.7%,4.4%,1.6%,respectively,P<0.01.The in-hospital MACCE rates in A,B,C group were 5.7%,2.0%,1.0%,respectively,P<0.01. The long-term MACCE rates in A,B,C group were 18.8%,11.6%,11.7%,respectively,P<0.05.The COX regression showed that A group had the highest risk of death(HR 3.646,95%CI 1.517-8.762);B group had higher risk of death(HR 2.184,95%CI 1.321-5.684).Conclusion:The patients with LVEF≤40% have higher long-term mortality than the patients with LVEF>41%.