老年女性糖尿病合并急性冠状动脉综合征患者完全与不完全血运重建的预后分析

目的 探讨老年女性糖尿病(DM)合并急性冠状动脉综合征(ACS)患者完全及不完全血运重建策略对预后的影响.方法 回顾性分析2010年1月至2017年12月于郑州人民医院接受经皮冠状动脉介入治疗(PCI)的多支血管病变的389例老年女性DM合并ACS患者的临床资料,按照冠状动脉血运重建方式分为完全血运重建(CR)组187...

Prognostic analysis of complete and incomplete revascularization in elderly women with diabetes mellitus complicated with acute coronary syndrome

Objective To investigate the effect of complete and incomplete revascularization strategy on the prognosis in elderly female patients with diabetes mellitus(DM)complicated with acute coronary syndrome(ACS).Methods A total of 389 elderly female patients of ACS with multivessel disease complicated with DM who underwent percutaneous coronary intervention in People’s Hospital of Zhengzhou from January 2010 to December 2017 were retrospectively analyzed.According to the method of coronary revascularization,187 cases were divided into complete revascularization group(CR group)and 202 cases were divided into incomplete revascularization group(IR group).The primary endpoints were allcause death,cardiac death and myocardial infarction;the secondary endpoint was the composite endpoint of major adverse cardiac and cerebrovascular events(MACCE),including cardiac death,non-fatal myocardial infarction,ischemia driven revascularization,stent thrombosis,and stroke.Results There was no significant difference in the incidence of cardiovascular events during hospitalization and all-cause death,cardiac death and myocardial infarction during the follow-up period between the two groups(all P>0.05).Within 36 months after percutaneous coronary intervention,compared with CR group,the incidences of MACCE30.7%(62/202)vs.14.4%(27/187),χ²=14.541,P=0.00],non-fatal myocardial infarction7.4%(15/202)vs.2.1%(4/187),χ²=4.759,P=0.02],ischemia driven revascularization14.4%(29/202)vs.3.7%(7/187),χ²=13.024,P=0.00],angina pectoris28.2%(57/202)vs.6.4%(12/187),χ²=31.629,P=0.00]and readmission36.1%(73/202)vs.8.0%(15/187),χ²=43.857,P=0.00]were significantly higher in IR group.There was no significant difference in the incidence of stent thrombosis,stroke and massive hemorrhage between the two groups(all P>0.05).Conclusions Compared with CR,elderly female patients with DM complicated with ACS underwent IR have higher incidence of postoperative MACCE,angina recurrence,revascularization and rehospitalization.