75岁及以上老年患者经皮冠状动脉介入治疗术后远期预后的性别差异

摘要

Objective: To explore the gender differences of long term outcomes in patients at 75 years or elder after percutaneous coronary intervention (PCI) treatment. Methods: A total of 29211 consecutive patients who received PCI in our hospital from 2004-04 to 2010-11 were retrospectively studied. The patients were divided into 4 group: Group① Female ≥ 75 years of age,n=521, Group② Female < 7 5 years,n=5666 and Group③ Male ≥75 years,n=1098, Group④ Male < 75 years group,n= 21926. The in-hospital and long-term clinical outcomes after PCI treatment were compared among different groups. Results: The in-hospital cardiac death in Group① was higher than the other 3 groups,P<0.05. Cox proportional hazard model analysis indicated that compared with Group② and Group④, the female ≥ 75 years was the independent risk factor for cardiac death (HR=2.53, 95% CI 1.15-5.59; HR=2.22, 95% CI 1.26-3.91) and cardiac death/MI (HR=2.26, 95% CI 1.27-4.03; HR=2.25, 95% CI 1.44-3.51). While compared with the male ≥75 years, the female ≥ 75 years was not an independent risk factor for cardiac death (HR=1.30) and cardiac death/MI (HR=1.21). Conclusion: Compared with other age groups, female patients at the age ≥ 75 years could have worse in-hospital and long-term outcomes after PCI, while it was not the independent risk factor for cardiac death and cardiac death/MI in patients after PCI treatment.%目的:评价75岁及以上老年患者在经皮冠状动脉介入治疗(PCI)术后远期预后是否存在性别差异.方法:连续入选2004-04至2010-11期间在我院行PCI的29 211例冠心病患者,分为:≥75岁女性组(521例)、<75岁女性组(5 666例)、≥75岁男性组(1 098例)和<75岁男性组(21 926例).比较各组患者PCI术后住院期和远期预后.结果:住院期间,≥75岁女性组心原性死亡发生率明显高于其他三组.COX比例风险模型分析显示:与<75岁女性及<75岁男性比,≥75岁女性是心原性死亡(HR=2.53,95% CI:1.15~5.59;HR=2.22,95% CI:1.26~3.91)和心原性死亡/心肌梗死(HR=2.26,95% CI:1.27~4.03;HR=2.25,95% CI:1.44~3.51)的独立危险因素.但与≥75岁男性相比,≥75岁女性不是心原性死亡(HR=1.30)和心原性死亡/心肌梗死(HR=1.21)的独立危险因素.结论:与其他人群相比,75岁及以上老年女性PCI术后住院期和远期预后较差,但其不是PCI术后预后不佳的独立危险因素.