年龄＞75岁老年患者冠状动脉介入治疗随访研究

目的评价年龄>75岁老年患者冠状动脉介入治疗术后远期效果,了解老年人介入术后的有效性。方法 351例行冠状动脉介入患者,按年龄分为普通老年组(≤75岁,n=180)和>75岁老年组(n=171),了解年龄>75岁患者一般临床资料、冠状动脉造影情况、冠状动脉介入术后1年心肌梗死发生率、再次冠状动脉介入率及不良事件发生率等。结果 >75岁老年组高血压、糖尿病患病率升高(P<0.05),冠状动脉病变以多支病变为主(P<0.05),左回旋支和右冠状动脉病变明显高于普通老年组(P<0.05),冠状动脉介入术后心源性病死率、再次冠状动脉介入治疗率、冠状动脉搭桥率等明显高于普通老年组(P<0.05)。结论年龄>75岁患者冠心病多并发高血压、糖尿病等,冠状动脉病变重而且复杂,冠状动脉介入治疗术后心血管发生率升高,不能减少远期死亡率。

Long Term Outcomes of Percutaneous Coronary Intervention in Elderly Patients Aged 75 Years and Older

Aim To evaluate the long term clinical results in elderly patients(>75 years) with coronary artery disease after percutaneous coronary intervention.Methods From January 2008 to January 2010,351 patients underwent percutaneous coronary intervention in the Chinese PLA General Hospital were divided into two groups,the number of normal group(≤75 years old) was 180,the elderly group(>75 years old) was 171,general clinical data and the result of coronary angiography were recorded,the rate of myocardial infarction,repeated percutaneous coronary intervention and adverse events after percutaneous coronary intervention were detected.Results In age>75 years old group,the incidence of hypertension and diabetes increased(P<0.05),they had multiple coronary artery lesion,the rate of left circumflex artery and right coronary artery lesion were significantly higher than the normal group(P<0.05),cardiac mortality,repeated percutaneous coronary intervention,coronary artery bypass rate increased significantly in elderly group(P<0.05).Conclusion Many elderly patients with coronary heart disease suffered from hypertension and diabetes,coronary artery lesions in elderly patients were more complex.Cardiac mortality,repeated percutaneous coronary intervention,coronary artery bypass rate increased in elderly group,PCI can not reduce the long-term mortality.