Hejazi Seyed Fakhreddin, Iranirad Leili, Doostali Kobra, Khodadadi Narges, Norouzi Sameeye
Department of Cardiology, Shahid Beheshti, Qom University of Medical Science and Health Services, Qom, Iran.
Department of Medicine, Shahid Beheshti, Qom University of Medical Science and Health Services, Qom, Iran.
Cardiol Res. 2017 Oct;8(5):199-205. doi: 10.14740/cr582e. Epub 2017 Oct 27.
As population growth leads to an increase in the number of the elderly with coronary artery disease, an evaluation of the clinical outcomes of percutaneous coronary intervention (PCI) in the elderly patients seems to be essential.
A prospective, observational cohort study was performed on 468 patients in two groups of elderly and non-elderly patients (mean age: 60.01 ± 10.84 years; ≥ 70 years, 20.1%; men, 62%) who underwent PCI, to evaluate the procedural success and in-hospital major and minor adverse cardiovascular events in the elderly patients.
The procedural success rate was significantly lower (95.7% vs. 99.5%, P = 0.017) and the rates of in-hospital complications were significantly higher (10.6% vs. 0.8%, P < 0.0001) in elderly (+70) than in non-elderly patients. On the basis of a multivariate analysis, being elderly was not an independent predictor of procedural failure, but increased the chance of in-hospital complications to 8% higher (odds ratio: 0.08; 95% confidence interval: 0.01 - 0.39; P = 0.002).
Regardless of the difference in the procedural success and in-hospital complication rates between our two study groups, aging is not an important predictor of them. Furthermore, PCI should not be refused in elderly patients if indicated.
随着人口增长导致冠心病老年患者数量增加,评估老年患者经皮冠状动脉介入治疗(PCI)的临床结局似乎至关重要。
对468例行PCI的患者进行前瞻性观察队列研究,分为老年组和非老年组(平均年龄:60.01±10.84岁;≥70岁者占20.1%;男性占62%),以评估老年患者的手术成功率及住院期间主要和次要不良心血管事件。
老年(≥70岁)患者的手术成功率显著较低(95.7%对99.5%,P = 0.017),住院并发症发生率显著较高(10.6%对0.8%,P < 0.0001)。多因素分析显示,高龄并非手术失败的独立预测因素,但使住院并发症发生几率增加8%(比值比:0.08;95%置信区间:0.01 - 0.39;P = 0.002)。
尽管我们两个研究组在手术成功率和住院并发症发生率上存在差异,但年龄并非其重要预测因素。此外,老年患者如有指征不应拒绝PCI治疗。