Objective To follow up long-term clinical events and compare the long-term prognosis between partial and complete revascularization in octogenarians with coronary artery disease.Methods A total of 108 patients aged 80-88 years who underwent elective percutaneous coronary intervention (PCI) in cardiology department of Huashan Hospital were divided into complete revascularization group (n=47) and partial revascularization group (n=61).They were followed up for long-term major adverse cardiovascular events from Jan.1 2005 to Dec.31 2008.Results There were no statistically significant differences in age,percent of female,prevalence of hypertension,diabetes,hyperlipidemia,unstable angina,smoking and renal dysfunction between the groups(all P＞0.05).And the angiography results showed no difference at the number and location of coronary artery lesions,including prevalence of single-vessel disease [15 cases(24.6％)vs.8 cases (17.0％)],dual-vessel disease [18 cases(29.5％) vs.15 cases(31.9％)] and that of tri-vessel disease [28 cases(45.9 ％) vs.24 cases (51.1 ％)] between partial and complete revascularization groups (all P＞0.05).The follow-up time in two groups were (1235±508)d and (1216±560)d (t=0.24,P＞0.05).All-cause death [ 10 cases ( 16.4 ％) vs.8 cases ( 17.0％)],cardiovascular death [8 cases (13.1％) vs.7 cases(14.9％)],hospitalization with angina [12 cases (19.7％) vs.9 cases (19.1 ％)],with hypertension [7 cases( 11.5 ％)vs.5 cases (10.6 ％)],with cardiac arrhythmia [5cases(8.2％) vs.4 cases(8.5％)],with chronic heart failure [4 cases(6.6％)vs.3 cases(6.4％)],and with all-cause cardiovascular disease [33 cases (54.1％) vs.25 cases(53.2％)] had no significant differences between partial and complete revascularization groups (all P ＞ 0.05).Conclusions Long-term prognosis of partial and complete revascularization is similar in octogenarians with coronary artery disease.%目的 随访年龄80岁及以上患者择期经皮冠状动脉介入术后的长期临床事件,比较部分血运重建组与完全血运重建组患者的长期预后.方法 回顾性分析2005年1月1日至2008年12月31日在复旦大学附属华山医院心内科择期冠状动脉介入治疗患者108例,年龄80～88岁,按是否完全血运重建分为完全血运重建组(47例)和部分血运重建组(61例),随访其长期主要心血管事件.结果 部分血运重建组与完全血运重建组患者年龄、性别、高血压、糖尿病、高脂血症、不稳定心绞痛、吸烟史、慢性肾功能不全等临床资料比较,差异无统计学意义(均P＞0.05).两组造影结果冠状动脉病变部位差异无统计学意义(P＞0.05)；部分血运重建组和完全血运重建组单支、2支、3支及以上病变分别为15例(24.6％)与8例(17.0％)、18例(29.5％)与15例(31.9％)、28例(45.9％)与24例(51.1％),差异无统计学意义(x2值分别为0.91、0.07、0.28,均P＞0.05).随访时间部分血运重建组和完全血运重建组分别为(1235±508) d 和(1216±560)d(t=0.24,P＞0.05)；随访结果全因死亡分别为10例(16.4％)与8例(17.0％)、心血管死亡8例(13.1％)与7例(14.9％)、心绞痛住院12例(19.7％)与9例(19.1％)、高血压住院7例(11.5％)与5例(10.6％)、心律失常住院5例(8.2％)与4例(8.5％)、心力衰竭住院4例(6.6％)与3例(6.4％)、心血管原因住院33例(54.1％)与25例(53.2％),差异无统计学意义(均P＞0.05).结论 年龄80岁及以上冠心病患者冠状动脉部分血运重建与完全血运重建的长期预后相似.
展开▼
