摘要
目的:冠状动脉旁路移植术(CABG)一直是左主干病变的首选治疗,关于高龄左主干病变但不宜行CABG治疗的患者临床研究较少。本研究针对这一特殊人群进行经皮冠状动脉介入术(PCI)治疗后的临床情况进行随访。方法:入选年龄≥75岁不宜行CABG治疗的无保护左主干病变患者,随访患者的临床终点事件,死亡、心源性死亡、心肌梗死及靶血管重建。结果:研究共入选115例高龄左主干病变患者。平均年龄(78.3±2.6)岁,平均Syntax评分和Euroscore评分为(29.3±6.1)和(7.8±4.2),随访总病死率是9.5%,心源性死亡、心肌梗死及靶血管重建率分别为7%,6.1%及6.1%,MACCE事件发生率为16.5%。男性和慢性肾功能不全与全因死亡显著相关。结论:PCI治疗为高龄不宜行CABG治疗的左主干患者提供了α-选择。男性和慢性肾功能不全与全因死亡显著相关。
Objective：Coronary artery bypass grafting（CABG）is considered the standard treatment for unprotected left main coronary stenosis,few studies have reported on clinical outcomes in elderly patients undergoing percutaneous coronary intervention（PCI）.We sought to assess clinical outcomes of elderly patients（age≥75years） undergoing PCI for unprotected left main stenosis not suitable for bypass surgery.Methods： ALL patients with unprotected left main stenosis were treated with stent implantation were consecutively enrolled.Primary outcome was the composite of death,myocardial infarction（MI）,or target lession revascularization（TLR）.Results： The study included 115 consecutive patients who were treated with drug-eluting stents.Mean age was（78.3±2.6）years,and mean Syntax score and EuroSCORE were（29.3±6.1）And（7.8±4.2）,respectively.The overall mortality at the end follow up was 9.5%,the rates of major adverse cardiacdeath,nonfatal acute MI and target lesion revascularization were 7%,6.1%,6.1%,respectively.MACCE is 16.5%.Male and renal insufficiency was significantly related with all cause mortality.Conclusion： PCI treatment is feasible in elderly patients with unprotected left main stenosis who were not suitable for CABG.Male and renal insufficiency was predictors of poor prognosis.
出处
《心肺血管病杂志》
CAS
2013年第3期251-254,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
左主干病变
高龄
冠状动脉介入治疗
COX回归分析
Left main coronary disease
Eldly patients
Percutaneous coronary intervention
Cox regression
