高龄老年急性冠脉综合征合并糖尿病患者不同血运重建的预后分析
Prognosis of different revascularizations in elderly patients with acute coronary syndrome complicated by diabetes
陈奇 1刘洋 1姬劲锐 1薛斌 1吴雷 1万冬宇 1刘恒亮1
作者信息
- 1. 450002 郑州,河南中医药大学第五临床医学院(郑州人民医院)心内科
- 折叠
摘要
目的 探讨高龄老年糖尿病合并急性冠脉综合征(ACS)多支血管病变(MVD)患者经皮冠状动脉介入治疗(PCI)完全(CR)及不完全血运重建(IR)方式对预后的影响.方法 回顾性分析2012年6月至2019年12月期间于河南中医药大学附属郑州人民医院接受PCI治疗的糖尿病ACS合并MVD高龄老年患者229例,根据患者接受PCI血运重建方式分为:CR组(92例)和IR组(137例).分析3年随访主要终点事件(全因死亡、心源性死亡、心肌梗死);次要终点事件为主要不良心脑血管事件(MACCE)的复合终点事件.结果 3年随访期内主要终点事件:IR组全因死亡(18.25%vs.8.69%,P=0.044)、心源性死亡(16.79%vs.7.61%,P=0.044)、心肌梗死(8.33%vs.5.43%,P=0.021),显著高于CR组;次要终点事件:IR组总MACCE事件(56.20%vs.21.73%,P=0.000)、缺血驱动的再次血运重建(18.98%vs.2.24%,P=0.001)、心绞痛复发率(24.09%vs.7.61%,P=0.001)和再次住院率(91.97%vs.13.13%,P=0.000)显著高于CR组.结论 高龄老年ACS合并糖尿病MVD患者CR可减少术后MACCE发生率.
Abstract
Objective To discuss the influence of complete revascularization(CR)and incomplete revascularization(IR)on prognosis in elderly patients with acute coronary syndrome-multi-vessel disease(ACS-MVD)complicated by diabetes after percutaneous coronary intervention(PCI).Methods The elderly patients with ACS-MVD complicated by diabetes(n=229)received PCI were retrospectively analyzed in Zhengzhou People's Hospital affiliated to Henan University of Traditional Chinese Medicine from June 2012 to Dec.2019.All patients were divided,according to revascularization types of PCI,into CR group(n=92)and IR group(n=137).The main end-point events(all-cause death,cardiac death,myocardial infarction)were analyzed in 3-y follow-up period,and secondary end-point events were composite end-point events of major adverse cardiovascular and cerebrovascular events(MACCE).Results The incidence rates of main end-point events were significantly higher in IR group than those in CR group,including all-cause death(18.25%vs.8.69%,P=0.044),cardiac death(16.79%vs.7.61%,P=0.044)and myocardial infarction(8.33%vs.5.43%,P=0.021).The incidence rates of secondary end-point events were significantly higher in IR group than those in CR group,including MACCE(56.20%vs.21.73%,P=0.000),ischemia-driven revascularization(18.98%vs.2.24%,P=0.001),angina recurrence rate(24.09%vs.7.61%,P=0.001)and readmission rate(91.97%vs.13.13%,P=0.000).Conclusion The incidence of MACCE can be reduced by CR in elderly patients with ACS-MVD complicated by diabetes.
关键词
急性冠脉综合征/经皮冠脉介入治疗/2型糖尿病/血运重建/心脑血管事件Key words
Acute coronary syndrome/Percutaneous coronary intervention/Type 2 diabetes mellitus/Revascularizations/Cardiovascular and cerebrovascular events引用本文复制引用
基金项目
河南省科技攻关计划(172102310309)
河南省医学科技攻关计划(LHGJ20191067)
出版年
2024
NETL
NSTL
万方数据