Analysis of influencing factors of major adverse cardiovascular events in elderly patients with coronary heart disease after percutaneous coronary intervention
Objective To explore the influencing factors of major adverse cardiovascular events(MACE)in elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods The clinical data of 148 elderly patients with coronary heart disease who underwent successful PCI were retrospectively analyzed,and the patients were followed up for 12 months after discharge from the hospital to record the occurrence of MACE.The clinical data(gender,age,body mass index,chronic disease history,smoking and drinking history,cardiac function grading,number of coronary artery lesions,and related biochemical indicators)of patients were collected.Univariate and multivariate Logistic unconditional regression analysis were used to analyze the influencing factors of MACE in elderly patients with coronary heart disease after PCI.Results In 148 elderly patients with coronary heart disease treated with PCI,18 cases of MACE occurred after the operation,with an incidence rate of 12.16%,including 9 cases of recurrent angina,5 cases of recurrent myocardial infarction,3 cases of arrhythmia,and 1 case of heart failure.The 18 patients who developed MACE after surgery were set up as the MACE group,and the rest were set up as the non-MACE group.Univariate analysis showed that the differences in age,body mass index,family history of coronary heart disease,history of hypertension,history of diabetes mellitus,history of hyperlipidemia,history of smoking,cardiac function grading,number of coronary artery lesions,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol and fasting blood glucose were statistically significant when comparing the MACE group with the non-MACE group(P<0.05).Factors with statistical significance in univariate analysis were added to multivariate regression analysis.The results showed that age[OR=3.831;95%CI=(1.054,6.376)],history of hypertension[OR=5.392;95%CI=(2.031,8.581)],history of diabetes[OR=7.404;95%CI=(2.273,12.692)],history of hyperlipidemia[OR=1.883;95%CI=(1.065,2.275)],smoking history[OR=3.831;95%CI=(1.578,6.004)],cardiac function grading[OR=5.109;95%CI=(2.003,8.284)],number of coronary artery lesions[OR=1.505;95%CI=(1.016,3.003)],total cholesterol[OR=2.175;95%CI=(1.177,3.236)],triglyceride[OR=2.010;95%CI=(1.141,3.389)],high density lipoprotein cholesterol[OR=1.674;95%CI=(1.034,2.473)],fasting blood glucose[OR=1.881;95%CI=(1.202,3.003)]were the influencing factors for the occurrence of MACE after PCI(P<0.05).Conclusion Elderly patients with coronary heart disease should be alert to postoperative MACE after PCI.The main risk factors include age≥70 years old,history of chronic disease,history of smoking,high cardiac function grade,number of coronary artery lesions≥2,hyperlipidemia and hyperglycemia,etc.In clinical practice,active treatment of underlying diseases and improvement of cardiac function,and good management of blood glucose and lipids are needed to help improve the prognosis of patients.
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