Objective To investigate the effect of complete revascularization strategy on the prognosis of elderly patients suffering from acute ST-segment elevated myocardial infarction(STEMI)complicated with multivessel disease(MVD). Methods A total of 390 elderly patients(over 60 years old)suffering from acute STEMI with MVD treated by clinical revascularization administration were enrolled for the study and divided into complete revascularization group(CR group,n=139)and non-complete revascularization group(NCR group,n=251). The effect of complete re-vascularization strategy on the prognosis was then analyzed by COX regression analysis. Results Compared with the NCR group,the patients of the CR group are younger and with a higher ratio of old myocardial infarction ,as well as the average number of stents ,and the mean value of total stent length is larger. The application of calcium channel blocker for post-operation patients is rarer as well. No significant difference can be found between the two groups on the ratio of post-operation all-cause mortality,cardiac mortality,nonfatal myocardial infarction,unplanned repeat revas-cularization. Multivariate COX analysis showed that the complete revascularization had no obvious difference on the prognosis of these patients be-tween the two groups. Conclusion There is individual diversity in the revascularization strategy choosing for elderly patients of acute STEMI alongside MVD;however,the prognosis is not significantly improved.%目的 探讨完全血运重建策略对老年急性ST段抬高型心肌梗死合并多支血管病变患者预后的影响.方法 连续入选390例急性ST段抬高型心肌梗死合并多支血管病变的老年患者(年龄>60岁),根据是否进行完全血运重建分为完全血运重建组(CR组,n=139)和非完全血运重建组(NCR组,n=251).通过COX回归分析研究完全血运重建对老年急性ST段抬高型心肌梗死合并多支血管病变患者预后的影响.结果 与NCR组相比,CR组年龄更小,既往罹患陈旧性心肌梗死比例更高,平均支架个数更多,平均支架总长度更长,术后钙通道阻滞剂应用比例更低.术后随访显示,2组患者的全因死亡、心因死亡、非致死性心肌梗死、非计划再次血运重建均无显著差异.多因素COX分析显示,完全血运重建策略对老年急性ST段抬高型心肌梗死合并多支血管病变的患者的预后无显著影响.结论 老年急性ST段抬高型心肌梗死合并多支血管病变的患者选择完全血运重建策略与否在临床方面存在个体性差异,但预后并未显著改善.
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