Analysis Of Prognosis Of Coronary Heart Disease Treated By PCI

Objective: The purpose of this paper is to analyze the effectiveness of PCI,explore the changes in QOL of patients with CHD after PCI for 6 months and the relevant factors affecting the improvement of QOL.Methods: Patients with CHD who received PCI in Specialized Hospital and General Hospital from August 2011 to September 2017 were prospectively included in this study.Firstly,descriptive analysis was conducted on the basic information of the patients before and 6 months after surgery,including the general situation of the patients,previous medical history,physical examination,basic information related to surgery,medication during hospitalization and expenses.Secondly,the QOL of patients with CHD was analyzed.Seattle angina questionnaire(SAQ)was used to score the patients before and 6 months after surgery,and the improvement of the QOL of the patients was investigated from different dimensions.The Partial Least Square Regression(PLSR)and traditional Multiple Linear Regression(MLR)were used to investigate the factors influencing the improvement of QOL in patients with CHD,the difference between the SAQ scores of patients 6 months after the operation and those before the operation was taken as the dependent variable,and the basic information of the patients was taken as the independent variable.And the results of the two models were compared.All data analysis in this study was implemented using R Studio 3.5.0.Results:(1)The biochemical indexes of the patients improved significantly at 6 months after PCI compared with those before PCI.The median of triglyceride decreased from 1.49mmol/L to 1.39mmol/L,LDL decreased from 3.05mmol/L to 2.22mmol/L,HDL increased from 1.06mmol/L to 1.12mmol/L,Left ventricular ejection fraction(LVEF)increased from 54.00% to 58.00%.The paired Wilcoxon test of the variables 6 months after the operation and the preoperative values showed that the P values were all less than 0.05,with significant difference.(2)The SAQ scores of the five major items of the patients increased to different degrees at 6 months after the operation,and the paired Wilcoxon test of the values of the variables at 6 months after the operation and before the operation showed that the P values were all less than 0.05.The median of the three major items,physical limitation(PL),anginal frequency(AF)and anginal stability(AS),were significantly increased.The most significant improvement was found in AS.(3)The preoperative scores corresponding to each dimension were the factors influencing the improvement of each dimension of SAQ(P<0.05).The lower the preoperative score was,the better the improvement was 6 months after the operation of this dimension.In addition,the improvement in the degree of PL was influenced by the following factors: baseline LVEF,type of medical insurance,etc.The higher the LVEF at baseline,the better the improvement in PL.Factors influencing the improvement of AS include occupation,lesion site,etc.The recovery of unemployed patients is better than that of workers.The AS improved better in specialized hospitals.The improvement in AF was influenced by baseline PL.Factors influencing improvement in TS included occupation,baseline PL,etc.The improvement of TS was better among the commercial service workers.Patients in general hospitals had better TS.Factors influencing improvement in DP included occupation,baseline AS,etc.The improvement of DP was better in the patients who were professional technicians,but worse in the unemployed patients.Conclusions:(1)The biochemical indexes and QOL of patients with CHD is significantly improved 6 months after PCI,and PCI technology can significantly improve the QOL with CHD.(2)The improvement of patients’ QOL 6 months after surgery was related to the preoperative QOL.The worse the preoperative QOL was,the more significant the postoperative improvement was,and PCI was especially suitable for patients with poor QOL.(3)The influence factors of QOL improvement as follows: preoperative QOL,lesion site,baseline LVEF,etc.Patients in specialized hospitals improved better in AS after PCI,while patients in general hospitals improved better in TS and DP.The QOL of patients with good LVEF and no history of dyslipidemia improved significantly after PCI.Patients with high educational level had more significant improvement in TS and DP,and patients with more rest time had more significant improvement of QOL.