| ObjectiveCoronary atherosclerotic heart disease (coronary heart disease) is a complexdisease that impares humans’ health and life, in our country, we have a highermorbidity of coronary heart disease and in a condition of escalating trend. Therevascularization surgery for coronary heart disease includes Percutaneous CoronaryIntervention (PCI) and Coronary Artery Bypass Grafting (CABG), both of them haveadvantages and disadvantages. The mian objective of this study is to comparableanalyze the clinical data between the patients who received PCI or CABG treatment,and compare the differences between PCI and CABG in the aspects of therapeuticregimen, curative effect, survival rate, as well as analyze the relevant risk factorsabout PCI and CABG, providing some significant clinical data for the treatment ofcoronary heart disease.MethodRetrospective analysis of the coronary heart disease patients who receivedtreatment in the hospital on1st, January,2009to30th, June,2012.1790cases wereincluded in this study, among them,1226cases were received PCI treatment,drug-eluting stent was adopted for all of the patients in PCI group,564cases werereceived CABG treatment. We recorded and analyzed the clinical data, results ofaccessory examination, the outcomes after PCI or CABG treatment, the follow upvisiting was lasting for16to18months. In this study, we compared the basicinformation, baseline levels, features, classification, complications during operationand post-operation, major adverse cardiovascular events, re-hospitalization andre-operation during follow up visiting between PCI and CABG group, and analyzedthe relevant risk factors about PCI and CABG. During the data statistics and analysis,measurement data was recorded by mean±standard deviation (x±s), SPSS18.0wasused for statistic analysis, among them, t test was used for the comparison of meanvalues, chisquare test or Fisher test were used for enumeration data, p<0.05wasconsidered for statistically significantly.ResultsAccording to the two groups of patients admitted to hospital statistics showedthat between PCI and CABG groups were gender, age, body mass index (BMI) wasno statistically significant difference (p>0.05), but the majority of patients are men,accounting for72.6%and74.3%, the age distribution of the two groups were concentrated in the50to75years old.PCI and CABG groups were combined presence of disease conditions, includinghypertension, diabetes, no significant difference in the proportion of patients withhypertension between the two groups, but the proportion of CABG patients withdiabetes is higher than the PCI group, the difference was statistically significant (p<0.05);Blood biochemical tests showed that patients treated with PCI troponin levels onadmission were significantly higher than CABG patients, may be associated withmultiple PCI patients hospitalized with acute onset of relevant, PCI and CABG grouppatients uric acid, urea, fasting blood glucose, lipid protein a, lipoprotein b, nohigh-density lipoprotein, total cholesterol, triglycerides, white blood cells, plateletsand hemoglobin levels significantly different (p>0.05), but creatinine in patients withCABG group, lipoprotein a, low-density lipoprotein levels significantly higher thanthe PCI group, the difference was significant (p <0.05);Coronary angiography showed: PCI portfolio and left anterior descending artery,right coronary ratio is higher than CABG group, the difference was statisticallysignificant (p <0.05); CABG group: Merge Left main disease is higher than the PCIgroup, the proportion is higher than the combined circumflex artery PCI group. Thesedifferences were statistically significant (p <0.05). Proportion of patients withthree-vessel disease and the presence of the CABG group was significantly higherthan the PCI group, the difference was statistically significant (p <0.05); coronaryartery lesions: PCI group,36.8%were single-vessel disease CABG group wassignificantly higher than2.1%, the difference was statistically significant. PCI groupdouble vessel disease accounted for22.8%,33.9%, significantly higher than thedifference was statistically significant. CABG group three diseases accounted for75.1%of the PCI group was significantly higher than29.3%, the difference wasstatistically significant.Clinical data complete a total of1790cases of cases in which there are1226cases PCI group, CABG group had564cases. Baseline of these patients, the results ofbiochemical tests during hospitalization, coronary lesions and major adversecardiovascular events for statistical analysis, follow-up results of tworevascularization during hospitalization showed, PCI group primary endpoint events:nonfatal recurrent myocardial infarction, all-cause mortality with CABG groupsimilar (nonfatal recurrent myocardial infarction: PCI group1.21%(15/1226) vs CABG group0.89%(5/564), P>0.05; all-cause mortality: PCI group3.90%(48/1226)vs3.47%(20/564), P>0.05); revascularization in the PCI group was significantlyhigher than in the CABG group (17.26%(89/1226) vs5.85%(33/564), p <0.05).Secondary endpoints: recurrent angina PCI group than the CABG group (9.1%(112/1226) vs4.27%(24/564), p <0.05)ConclusionsPCI and CABG are the primary therapeutic revascularization surgery forcoronary heart disease, both of them have respective advantages and disadvantages.Therefore, in the treatment of coronary heart disease, the clinicians shouldcomprehensively analyze the general condition of the patients and make the optimizedtherapeutic schedule. In addition, the specific condition, relative risk factors should beincluded in making therapeutic schedule, with guidance of treatment guidelines, wecan make a individualized therapeutic schedule, for improving the survival rate andlife quality, the conclusions of this study are as follows:From the end of the event during hospitalization PCI group and the CABGgroup found, PCI and CABG groups group similar overall mortality, the differencewas not statistically significant; while another PCI revascularization group than in theCABG group, the difference was statistically significant, which vessels arecompletely redevelopment, CABG group was completely rebuilt in most vascularvessels, and PCI-based treatment is mainly for target lesion treatment, this differencemay cause the PCI group was further revascularization rate in the CABG group. |
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