| Objective:By observing the clinical data of elderly patients with coronary heart disease,analyze the characteristics and the relationship between the risk factors.follow-up of elderly patients undergoing percutaneous coronary intervention occurrence of short and medium term major adverse cardiovascular events after treatment(PCI),by analyzing its PCI after 2 years Prognosis.Predicting the risk factors of MACCE in the elderly after PCI treatment to improve the clinicians' knowledge of PCI in elderly patients and to provide safety and effectiveness for elderly patients with coronary heart disease.Method:1.materials,select from January 2015 to January 2016 Kunming Medical University First Affiliated Hospital of hospitalized patients with coronary heart disease.Incidence:(1)confirmed by coronary angiography(CA)for coronary heart disease,(2)age ? 65 years old,(3)all patients were the first PCI treatment,(4)each patient were at least one drug Eluting the stent.Exclusion criteria:a,suffering from other systems of serious diseases,such as malignant tumors,congenital heart disease,chronic respiratory disease,severe liver and kidney dysfunction,mental illness and so on.P<0.05 for the difference was statistically significant.Information includes:general information,clinical data,follow-up information.The data were pre-PCI data.2.follow-up,through the outpatient,discharge case room,telephone follow-up were obtained in three ways,up for 12 months to 24 months,included drug use situation,recurrent angina,myocardial infarction,repeat revascularization,hospitalized again due to cardiac events,brain Stroke,malignant heart events,the cause of death and so on.3.The SPSS 18.0 software was used for statistical analysis.The counting data were described by frequency(percentage).The x2 test was used to compare the data.Logistic regression was used for multivariate analysis,and the difference was statistically significant(P<0.05).Results:1.data analysis1.1 General datathere are 310 patients,the maximum age of 86 years,the minimum age of 65 years,mean age(71.01 ± 4.77)years,65.29 years old patients(140)45.2%,70-74 years old patients(92)29.7%,75%(28)19.4%,?80 years old patients(18)5.8%;male(211)68.1%,female(99)31.9%;smoking history patients(120)38.7%.Total 562 stenting,all drug-eluting stent?1.2 age groupingThe age group was divided into four groups,the most common hypertension(>50%),75 to 79 years old group or even 75.0%.Diabetes mellitus,hyperuricemia,dyslipidemia in the age of ? 65 years of age in patients with coronary heart disease were 28.7%,25.2%,28.4%,but the four diseases in the age group differences were not statistically significant.patients ?65 years of age with myocardial infarction hospitalized ratio of 58.4%,statistically significant differences in age groups.The total number of coronary artery lesions accounted for 48.4%of the total incidence of single-vessel disease and double-vessel disease,but the difference was not statistically significant.The incidence of left ventricular ejection fraction<50%had a positive correlation with age,but there was no significant difference.1.3 Gensini pointsWith the Gensini score grouping higher,the age was 1-3 years of age increased,scores increased with age increased,the difference between the points were statistically significant.The prevalence of diabetes increased with the increase of Gensini score,the ratio was 16.9%,23.6%,29.2%,30.3%,the difference was not statistically significant.The prevalence of dyslipidemia was 21.6%,25.0%,25.0%and 28.4%,respectively,with Gensini score,but there was no significant difference between the two groups.Gensini score was positively correlated with the number of stent placed and the number of coronary artery lesions,and the difference was statistically significant.Gensini score was positively correlated with the admission of myocardial infarction,the difference was statistically significant in each group.2.follow-up situation2.1 Drug takingdouble anti-drug taking<1 year patients accounted for 9.1%,MACCE incidence was 89.47%,the difference was statistically significant.patients without control of lipid-lowering drugs accounted for 36.80%,MACCE incidence was 61.06%,the difference was statistically significant.patients without control of uric acid drugs in patients with 43.00%,MACCE incidence was 88.24%,the difference was statistically significant.patients without control of blood pressure in patients with 35.50%,MACCE incidence was 36.70%,the difference was not statistically significant.patients without control of blood glucose patients accounted for 4.49%,MACCE incidence of 100.00%,the difference was not statistically significant.2.2 MACCE occurrencefollow-up results reveals that age,hypertension,diabetes,dyslipidemia,hyperuricemia,no regular drug use(double drug,control lipid drugs,control blood uric acid drugs),left ventricular ejection fraction<50%,high cardiac function grade,BNP?400pg/L,high sensitivity C-reactive protein in patients with 1 to 2 years after the occurrence of MACCE were no risk factors compared with the population of patients,there are significant correlations,differences are The mean value of ?2 was 23.951,6.140,4.527,4.708,13.809,(62.878,64.248,41.086),4.954,7.913,8.792,9.327,P<0.05.Age,hyperuricemia,left ventricular ejection fraction<50%,high cholesterol,diabetes is a risk factor for coronary heart disease patients after PCI MACCE>65 years of age 2 years,OR values were 1.117?3.206?1.944?3.874?2.461,P<0.05.Conclusion:1.elderly patients with coronary heart disease,may more complicated with high blood pressure,diabetes,hyperuricemia,dyslipidemia and other diseases.severe coronary artery disease,3 and multiple lesions in the high proportion in elderly patient.myocardial infarction admitted more common.2.Gensini integration can better assess the severity of coronary artery disease.age,diabetes,dyslipidemia and Gensini scores were positively correlated,there were 3 on the severity of coronary artery disease promoted,The more severe the severity of coronary artery disease,the higher the risk of myocardial infarction.3.Elderly patients with coronary heart disease taking DAPT and hypoglycemic drugs compliance with high rates of antihypertensive drugs and lipid-lowering drugs followed,high uric acid drug compliance rate difference;DAPT<1 year,no regular medication and 2 years occurred MACCE Related,which DAPT<1 year the most closely related.4.Age,hypertension,dyslipidemia,diabetes mellitus,hyperuricemia,and cardiac insufficiency are maybe the risk factors for MACCE in 2 years after PCI in elderly patients with coronary heart disease. |
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