Clinical Acessement Of Coronary Angiographic And Interventional Data In 733 Consecutive Elderly People From 2002 To 2007

OBJECTIVE To explore the epidemiological characteristics of the elderly and very elderly patients with coronary heart disease(CHD) risk factors, and to evaluat the effectiveness and safety of pecutaneous coronary intervention(PCI) of the elderly.METHOD All objects are accepted Judkins of coronary angiography, and are made in the light of Gensini Analysis referring coronary angiography results. The impact of different age, sex of the prevalence of CHD, numbers of stenosed coronary arteries and the extent of CHD was analyzed through all age groups. Urea nitrogen (Bun), creatinine (Cr), fibrinogen (FIB) was compared with or without CHD, also the three parameters were analyzed in 1-vesseal group, 2-vessel group and multi-vessel group of CHD patients. And finally through multiple regression analysis, the correlation of Gensini Score and risk factors was analyzed.In this study, 201 cases with PCI were divided into the younger group (<60-year-old group), the elderly group (60 to 74-year-old group) and the very elderly group (75 to 88-year-old group) with different complications. The distribution of coronary stents, PCI immediate success rate, postoperative complications and short to long-term effect after PCI (four weeks to three years follow-up ) of different age group was calculated with the major cardiac events (MACE) and the end points.RESULTS of four age groups (<60-year-old group, 60 to 69-year-old group, 70 to 79-year-old group, 80 years and over group) ,CHD incidence rate was 47.41%, 50.5%, 64.4%, 68.3% respectively, RR 1, 1.127, 1.242, 1.317, the age of the elderly group increased by each 10-year-old, the risk of CHD increased 12.70%, 24.20%, 31.70%. Men of all ages CHD incidence rate is higher than female, male to female risk of CHD of 1.39 times (p <0.01). Patients in Multi-vessel disease were older (p <0.01) than in the 2-vessel group and 1-vessel group. From <60-year-old group to 80 years and over group, Gensini Score gradually increased. Bun (p <0.05, p <0.05, p <0.05), Cr (p <0.01, p <0.01, p <0.01), FIB (p <0.05, p <0.05, p <0.01) and coronary heart disease were significantly Related, accompanied by increase of stenosed coronary arteries and Gensini Score, and multiple regression analysis showed that, Bun, Cr and FIB are integral independent risk factors of Gensini Score.In our study, 201 patients accept PCI, in the very aged group, the prevacence of hypertension (p=ns), hyperlipidemia (p <0.01), diabetes (p <0.01), ischemic stroke (p <0.01), renal dysfunction (p =ns) and the occurrence of liver disfuntion (p =ns) was higher than that old group and young patients.In the elderly and very elderly groups, the incidence of 1-vessel disease and simple disease was less than that in the younger group, but the 2-vessel and the multi-vessle disease was more frequent in the latter groups. From the younger group to the very elderly group, the Gensini Score increasing significantly. Apart from one case of occurrence of acute coronary thrombosis, one case of a coronary perforation, the whole target group involved in the treatment of coronary immediate success rate of 99.01% (199/201), with very elderly group 98.68%, eldrly group 98. 91% and younger group100%, and no significant difference was found.The complete revasculation in the very elderly group was much less than that in elderly group and in younger group. During follow-up period, the very elderly group was with MACE of 5.74 times more occurred than the younger group. Logistic Regression showed that incomplete revasculation was the independent risk factors of adverse events.CONCLUSION Aging, male was important risk factors of CHD, with accelerating the progress of CHD. Bun, Cr, FIB higher levels are an independent risk factor for CHD, and promote the development of coronary heart disease. There are indications of elderly with good tolerance of PCI, PCI immediate success rate was similar with young patients. Coronary angiography may give accurate detection of elderly patients with CHD (especially the silent type Patients with CHD), to make sever elderly patients with CHD accept early reperfusion therapy, significantly improving the prognosis, reduing the incidence of cardiac events.