Characteristics Of Coronary Lesions And One-year Outcom After Pci In Patients With Coronary Artery Disease Over 75 Years Old

In this study a retrospective analysis and comparison of elderly patients with coronary heart disease (≥75 years) coronary angiography of the lesion characteristics, and efficacy between different PCI strategies (complete and incomplete revascularization) in the treatment of nearly and long-term, designed for the development of elderly coronary heart disease in patients with treatment strategies provide a basis for intervention.Methods1.MaterialsSelect from August 2007 to July 2008 China Medical University Hospital loop medicine received a coronary angiography in all the elderly (age≥75 years) 120 patients with coronary heart disease. Over the same period (from April 2008 to July 2008) confirmed by coronary angiography≤60-year-old age group,148 patients with coronary heart disease.2. Assessment of coronary artery disease and PCIInvolving the left anterior descending, circumflex, the middle branch and main branch and right coronary vessels were a single-vessel disease, involving two branch for the two-vessel disease, involving three or three branch above or left main stenosis≥50% were for multi-vessel disease. Immediate PCI success criteria for stenting:residual stenosis rate of those lesions<20%, TIMI flow 3; simple PTCA:residual stenosis rate of those lesions<50%, TIMI flow grade 3. Complete revascularization and incomplete revascularization definition:all of the major coronary artery and its branches after PCI no more than 70%residual stenosis as a complete revascularization, any coronary artery and its branches for more than a residual stenosis of≥70%those with incomplete revascularization.3.Follow-upHospital cardiac death, non-fatal myocardial infarction, re-PCI or CABG. Long-term follow-up:The PCI-line treatment of elderly patients records (PCI after 1 year) major adverse cardiac events, including cardiac death, non-fatal myocardial infarction, because of recurrent angina or heart failure hospitalization, or re-PCI and CABG.4.Statistical MethodsThe measurement data between the two groups was used to compare continuous variables are the number of bilateral t test. Count data used to compare the X2 test.ResultsClinical and CAG comparison:≤60-year-old age group, male patients, smoking and high cholesterol was significantly higher than the proportion of senior citizens group. Age group of patients with left ventricular dysfunction, decreased lung function, history of cerebrovascular disease and renal dysfunction were significantly higher than the younger age group. OMI a high proportion of elderly patients (p<0.05 or p<0.01).Age group of patients with multi-vessel coronary artery disease, left main disease, total occlusion, diffuse disease, complex lesions (B2, C-type), and Gensini points were significantly higher than younger age groups, and single-vessel disease and complete revascularization was significantly lower than younger age group (p<0.05 or p<0.01). Two groups of target lesion PCI instantly vascular distribution and no difference in success rate (p> 0.05). Age group of PCI success rate was 97.3%.2.Follow-up Results:The age group of patients treated with PCI whether or not complete revascularization intervention, their hospital cardiac death, non-fatal myocardial infarction, the incidence of re-PCI or CABG was no significant difference; right age group of PCI-line treatment of 67 patients were followed up for 1 year MACE (cardiac death, non-fatal myocardial infarction, because of recurrent angina or heart failure hospitalization, re-line PCI or CABG), occurrence rate has no notable difference.both reach radiography follow-up rates and clinically there being no difference (p> 0.05). Conclusion1.The number and severity of coronary artery increased with increasing age. Elderly patients with coronary artery multi-vessel coronary heart disease, complex vascular lesions, left main disease, chronic Mi stenosis, vascular occlusion, calcified lesions is relatively more serious.2.In this study age group and younger age group of PCI success rate and incidence of severe complications was no significant difference, suggesting the involvement of the maturity of the technology center, PCI treatment of elderly patients with coronary heart disease is safe and feasible. Of age should not be a PCI treatment exclusion criteria.3.In this study, elderly patients with elective coronary interventional treatment, regardless of whether complete revascularization, the two one-year clinical endpoints after PCI there was no significant difference. Some of the elderly patients with coronary heart disease revascularization intervention is a feasible treatment options.