Long-term Prognosis Of Three-vessel Coronary Disease In Different Treatment Strategies And The Relationship With Risk Factors

Objective：A retrospective comparison of three prognosis of coronary vascular diseaseusing different treatment strategies, and the relationship between prognosis andclinical risk factors.Methods：First Hospital of Jilin University, Bethune cardiovascular centers1December201131January2013underwent coronary angiography displaysthree-vessel disease (TVD) in patients with152cases. Follow-up of majoradverse cardiovascular events (MACCE): cardiovascular-related death, recurrentmyocardial infarction, revascularization, stroke.1-2.5years of follow-up, mean18.5±3.55months.All patients are grouped according to the different treatmentstrategies, while patients with left main disease group was divided intoconservative medical group, PCI and CABG group group, the PCI group wasdivided into complete revascularization group and incomplete revascularizationgroup.Establish a selected group of patients with three treatment strategies andbasic information database, data were analyzed using SPSS software package.All data were analyzed statistically, count data to the chi-square (χ2) test, countdata to the number of cases (percentage) that the difference between using thechi-square (χ2) test and t test to compare two groups, P <0.05as havingsignificant differences.Results：1. the three groups of patients, the average age of67.26years old, theyoungest42.5years, maximum90.5years old. Men accounted for60.62%,accounting for39.38%of women. Smoking patients accounted for22.75%, accounting for15.86%of patients drinking; hypertensive patients accounted for30.25%, accounting for23.65%of patients with diabetes;2.TVD all three groups of patients, the overall incidence of MACCE, thehighest treatment group (P<0.05), were statistically different. All-causemortality in drug treatment group than in the PCI group and the CABG group (P<0.05), there was significant difference. Recurrent myocardial infarction, CABGgroup was significantly lower than the rate in the PCI group and theconservative treatment group (P <0.05), there was significant difference; CABGstroke incidence and conservative treatment group was significantly higher thanthe PCI group (P <0.05), the presence of statistically significant.3.PCI group, the overall incidence of MACCE, incompleterevascularization was significantly higher than the complete revascularizationgroup (P <0.01, significant differences exist in which all-cause death, stroke,recurrent myocardial infarction, revascularization, the former are higher than thelatter.4.TVD patients with left main disease patients, the overall incidence ofMACCE, drug treatment group was the highest (P<0.05), there were significantdifferences, there was no significant difference between PCI and CABG groupgroup.5.the patients were admitted to hospital-based clinical informationcorrelation analysis, independent risk factors for the occurrence of MACCEdrawn influence. Are: age, BMI, smoking history, family history of coronaryheart disease, hypertension, diabetes mellitus, history of MI. Notably, the greaterthe impact of hypertension and diabetes.Conclusion：For severe three-vessel coronary artery stenosis revascularization should beactively lines, PCI revascularization group was higher than in the CABG group,CABG group incidence of stroke in the PCI group. For left main disease, the overall incidence of MACCE the highest rate of drug treatment, the results canbe drawn contain three-vessel disease, including patients with left main diseaseshould actively revascularization surgery. However, relatively incompleterevascularization group and complete revascularization group, MACCEincidence of incomplete revascularization group higher, indicating thatthree-vessel disease in the revascularization process should be completerevascularization major blood vessels. Another study showed that age, BMI,smoking history, hypertension, diabetes mellitus and a history of myocardialinfarction were independent risk factors for MACCE, where a greater impact ofhypertension and diabetes.