复杂的皮肤穿冠状动脉干预在老年人的结果
Jonathan M Hanna1, Stephen Y Wang1, Ajar Kochar2,3
1Department of Internal Medicine Yale School of Medicine New Haven CT USA.
Journal of the American Heart Association
|September 30, 2023
概括
稳定缺血性心脏病的老年人复杂的皮肤冠状动脉干预 (PCI) 显示,目标病变再血管化的风险较低. 然而,复杂的PCI与在一年内因各种原因死亡的风险明显增加有关.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 干预心脏病学 干预心脏病学
背景情况:
- 复杂的穿皮冠状动脉干预 (PCI) 在老年患者 (≥75岁) 患有稳定的缺血性心脏病中越来越常见.
- 这种经历复杂PCI的人群的临床结果仍未得到充分研究.
研究的目的:
- 为了比较12个月的复杂和非复杂PCI之间的临床结果,在老年人中患有稳定的缺血性心脏病.
- 评估无事件生存率,全因死亡,目标病变再血管化和出血事件.
主要方法:
- 对513名接受选择性PCI的患者 (平均年龄为81岁) 进行了回顾性队列研究.
- 使用考克斯回归模型,比较复杂和非复杂的PCI组之间的结果.
- 分析了12个月无事件生存,因任何原因死亡,目标病变再血管化和出血.
主要成果:
- 复杂的PCI与较差无事件生存率 (80.4%与86.8%) 的非显著趋势有关.
- 在复杂的PCI组中,1年后所有原因的死亡率显著高于复杂的PCI组 (10.2%对5.9%;调整后HR1.97).
- 复杂的PCI显示了目标病变再血管化的风险较低 (2.2%对3.5%),但出血事件发生率相似.
结论:
- 在患有稳定缺血性心脏病的老年人中,复杂的PCI与减少重复手术的需求有关.
- 在这一群体中,复杂的PCI与非复杂的PCI相比,具有显著更高的1年全因死亡风险.
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