急诊冠状动脉介入治疗老年急性心肌梗死的疗效

目的　探讨急诊冠状动脉介入 (PCI)治疗老年急性心肌梗死 (AMI)的临床疗效。方法　 131例连续行急诊PCI的AMI患者分为老年组 (37例 )和非老年组 (94例 ) ,分析两组患者一般临床特征及心血管事件的发生率。结果　老年组女性、高血压和无血流现象显著多于非老年组 ,而吸烟、术后TIMI 3级血流和支架植入数显著少于非老年组。住院期间老年组患者病死率 (10 .8%)高于非老年组 (0 %) (P <0 .0 1) ,复合终点事件的发生率 (10 .8%)亦高于非老年组 (1.1%) (P <0 .0 1) ;而两组在不稳定性心绞痛、非致死性再次心肌梗死、非致死性心力衰竭和缺血性靶血管重建等方面的差异均无显著性。随访 6个月时 ,老年组患者总病死率 (16 .2 %)明显高于非老年组 (2 .1%) (P <0 .0 1) ,非致死性心力衰竭的发生率 (2 1.2 %)亦明显高于非老年组 (4.3%) (P <0 .0 1) ;但两组在不稳定性心绞痛、非致死性再次心肌梗死、缺血性靶血管重建及复合终点事件的差异均无显著性。结论　急诊PCI治疗老年AMI疗效显著 ,但不如非老年AMI。

Efficacy of emergency PCI in elderly patients with acute myocardial infarction

Objective To evaluate the efficacy of emergency percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI). Methods One hundred and thirty-one consecutive patients with AMI treated by emergency PCI were divided into the elderly AMI group (37 cases) and the non-elderly AMI group (94 cases). The baseline characteristics and cardiac events were analysed.Results In the elderly AMI group, female, hypertension and no-flow phenomena were more than those of the non-elderly AMI group, while smoking, TIMI-3 flow after the procedure and the proportion of stent implantation were less than those of the non-elderly AMI group. Compared with the non-elderly AMI group, in-hospital mortality (10.8% vs 0, P<0.01) and composite terminal events (10.8% vs 1.1%, P<0.01) were higher in the elderly AMI group, and no significant differences were observed in unstable angina, non-fatal reinfarction, non-fatal heart failure and ischemic target vessel revascularization between the two groups. During 6 months follow-up period, non-fatal heart failure (21.2% vs 4.3%, P<0.01) and total mortality (16.2% vs 2.1%, P<0.01) in the elderly AMI group were higher than those in the non-elderly AMI group, but there were no significant differences in unstable angina, non-fatal reinfarction and ischemic target vessel revascularization in the two groups (P>0.05).Conclusion The emergency PCI in the elderly AMI is effective, but not as good as that in the non-elderly AMI.