The Clinical Research Of Complete Or Incomplete Revascularization On Prognosis Of Patients With Multivessel Coronary Artery Disease

Objiective:This research is to retrospectively investigate the therapeutic effect of complete or incomplete revascularization or drug therapy in patients with multivessel coronary artery disease (MVD), As well as to identify the independent predictive factors of MCD patients in developing MACCE affecting the outcome. M ETHODS:From June 2008 to September 2009,160 patients with MVD treated in the inpatient department of cardiology were reviewed.According to treatment methods,160 patients were classified into complete revascularization group (n= 60),incomplete revascularization group (n=47) and the conservative group (n=47). The general conditions of the patients in three groups were collected and compared. Ejection factor (EF) of left ventricle were observed.The Primary end-Point was the happening of all cause death, the combined end-point was MACCE, including all cause death, recurrent infarction and the target vessel revascularization.Multivarite analysis was carried out using the Multiple logistic proportional hazards model to determine the variable relevant to the EF of left ventricle(LVEF). Results:There were no differences in sex,age, hypertension, hyperlipidemia, diabetes mellitus,smokers, NYHA, collareral circulations,the number of coronary stents and LVEF among three groups (P>0.05). After 6 months,the improvement of LVEF was remarkable higher in complete revascularization group and in incomplete revascularization group than in the conservative group(P= 0.000,P=0.000).There was not remarkable difference in the improvement of LVEF between complete revascularization group and incomplete revascularization group.The ratio of MACCE was found to be signifieantly different among three groups(P=0.009).The ratio of MACCE was remarkable higher in conversation group than in complete revascularization group (P=0.003), The ratio of MACCE was not remarkable different in incomplete revascularization group than in conversation group (P= 0.073).There was no remarkable diffenece between in complete revascularization group and in incomplete revascularization group(P=0.287). Multiple linear regression showed that hypertension,hyperlipidemia,man and smoke history were the negative dependend factors of LVEF.Conclusions:(1) complete revascularization treatment and incomplete revascularization treatment could remarkabley improve the patients' LVEF.And in complete revascularization treatment could decrease the MACCE ration than in incomplete revascularization treatment and in conversation treatment in treating MVD patients.(2) hypertension,hyperlipidemia,man and smoke history were the worsen factor of MVD patients.