Analysis Of Clinical Features And Prognosis Of Elderly Acute Myocardial Infarction Patients Undergoing Emergency PCI

Objective : In recent years,the number of elderly patients receiving emergency coronary intervention therapy is increasing day by day.Identifying the lesions of elderly patients,reducing the risk of adverse events and reducing the burden of symptoms,can help improve the quality of life of elderly patients after coronary intervention.Acute myocardial infarction(AMI)is one of the most common severe acute diseases in the emergency department,which is often found in the elderly group.It is a common disease in the elderly and the main cause of death and disability caused by coronary heart disease.To improve the treatment success rate,improve the quality of life and the prognosis of elderly AMI patients is a severe challenge faced by the accelerating aging society in China.At present,there are few relevant clinical studies on elderly patients.Due to their own characteristics,elderly patients often suffer from a variety of complications.Therefore,they are at high risk of receiving corresponding drugs and interventional therapy recommended by domestic and foreign guidelines.There is no unified and perfect consensus in the world,so it is urgent to summarize the current individualized and refined clinical experience in clinical practice.In this study,clinical data of emergency PCI patients were retrospectively analyzed to analyze the clinical characteristics of elderly patients over65 years old and the short-term prognosis of 6 months after emergency PCI treatment.It is hoped that this study can provide reference value for clinical practice.Methods: This study is a retrospective clinical study,and 226 patients who underwent emergency interventional surgery in our hospital from January 2018 to January 2019 were continuously selected.The latest global unified definition in 2012 was adopted in combination with the clinical symptoms,electrocardiogram and changes in myocardial markers,all of which met the diagnostic criteria for AMI.Taking 65 years as the cut-off point,there were 113 cases in the ?65 years group,including 91 males and 22 females,with an average age of(72.85±6.189)years,and 113 cases in the group < 65 years old,including 107 males and 6 females,with an average age of(51.75 ± 9.392)years.Clinical information of all patients was collected: 12-lead electrocardiogram,angiography results,echocardiography and other data,and the clinical characteristics,postoperative complications and short-term prognosis of the patients were analyzed.SPSS19.0 statistical software was used for processing.Results:1.The basic data of the two groups The proportion of female patients,hypertension and inferior wall myocardial infarction in the ?65 years old group increased significantly(p < 0.05),and the smoking patients in the < 65 years old group was higher(p <0.05).There was no significant difference in diabetes,dyslipidemia,COPD history between the two groups.2.Characteristics of emergency coronary angiography in two groups of patients According to the results of coronary angiography,there was no significant difference between the two groups in the proportion of single-vessel lesions,proportion of multi-vessel lesions and lesion site(p > 0.05).3.Postoperative complications in hospital There was no significant difference in the proportion of heart failure,severe arrhythmia,cardiogenic shock,recurrent myocardial infarction,ventricular wall segmental dyspnea,death and pulmonary infection complications during hospitalization.4.Follow-up at 6 months after surgery A short-term follow-up of 6 months after emergency PCI showed no significant difference in the total proportion of major cardiac adverse events between the two groups(P>0.05).MACE occurred in a total of 41 AMI patients 6 months after PCI,with an incidence of 18.1%,including 21 cases of stent thrombosis,8 cases of myocardial infarction,7 cases of malignant arrhythmia,3 cases of heart failure,and 1case of cardiogenic death.Further analysis showed that stent thrombosis was higher in elderly patients(P<0.05),and the incidence of death,recurrent myocardial infarction,heart failure and malignant arrhythmia in both groups was not statistically significant(P >0.05).Conclusion:1.In this study,age had no significant influence on the choice of emergency interventional treatment.Elderly patients undergoing emergency PCI have no significant disadvantage in terms of hospital complications compared with young patients.Emergency interventional therapy is still a good choice for elderly patients with acute myocardial infarction.2.There was no significant difference in the incidence of overall adverse cardiovascular events in elderly patients after emergency PCI,but the incidence of in-stent thrombosis was significantly increased.This study only conducted a short-term follow-up of 6 months,which was relatively short.Further clinical studies are needed to clearly evaluate the long-term prognosis of elderly patients.