摘要
目的 :观察 75岁以上非ST段抬高急性冠状动脉 (冠脉 )综合征患者选择性冠脉内支架术的安全性和远期预后。 方法 :连续 3 2 3例行选择性冠脉内支架术的非ST段抬高急性冠脉综合征患者 ,其中≥ 75岁患者 79例为高龄组 ,<75岁患者 2 44例为对照组。比较两组患者手术结果和远期预后。 结果 :两组支架术成功率和手术并发症率差异无显著性。随访期内 ,两组心绞痛复发、硝酸酯类药物停用、再入院、心功能改善、再次血运重建和病死率均无显著性差异 ,但高龄组心脏事件发生率较对照组显著减少 (15 7%vs .2 8 7% ,P =0 0 2 9)。多因素分析显示 ,年龄不是非ST段抬高急性冠脉综合征患者远期心脏事件的独立预测因素。 结论 :高龄非ST段抬高急性冠脉综合征患者选择性冠脉内支架术有良好的疗效和安全性 ,远期心脏事件发生率较年轻患者少。
Objective: To investigate the initial and long-term outcomes after coronary stenting in patients aged ≥75 years with non-ST-segment elevation acute coronary syndrome(ACS). Methods: Three hundred twenty-three consecutive patients with non-ST-segment elevation ACS underwent elective coronary stenting, including 79 patients aged ≥75 years (group A) and 244 patients aged <75 years (group B). The initial results and long-term follow-up outcomes were compared between the two groups. Results: Procedural success rate (93.7% vs. 96.3%) and complications (3.8% vs. 2.5%) were similar between the two groups (all p>0.05). There were no significant differences in recurrent angina, cessation of nitrates, re-admission, and improvement of cardiac function between the two groups (all p>0.05) during the follow-up period. Although differences of revascularization (14.3% vs. 23.9%) and mortality (1.4% vs. 3.0%) were not significant between the two groups (all p>0.05), occurrence rate of major adverse cardiac events was lower in group A than that in group B (15.7% vs. 28.7%, p=0.029). Multivariate analysis showed that age was not an independent predictor of major adverse cardiac events. Conclusion: Elective coronary stenting in elderly patients with non-ST-segment elevation ACS is safe and efficacious. Moreover, elderly patients may have fewer cardiac events than younger ones.
出处
《中国循环杂志》
CSCD
北大核心
2003年第3期188-190,共3页
Chinese Circulation Journal
