Šerpytis Rokas, Puodžiukaitė Lina, Petrauskas Saulius, Misonis Nerijus, Kurminas Mantas, Laucevičius Aleksandras, Šerpytis Pranas
Centre for Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Acta Med Litu. 2018;25(3):132-139. doi: 10.6001/actamedica.v25i3.3860.
The data on long-term outcomes for elderly patients with coronary artery disease who undergo invasive treatment is limited. This study aimed to assess long-term outcomes and risk factors for patients over 80 years of age who underwent revascularisation.
This single-centre retrospective study included ≥80-year-old patients who underwent coronary angiography between 2012 and 2014. Among 590 study patients, 411 patients had significant angiographic changes and had either a percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) performed. Baseline patient characteristics, including demographics, comorbidities, survival to hospital discharge, and long term mortality were analysed. Three-year mortality was assessed.
Three hundred sixty-nine (89.8%) patients underwent PCI and in 42 (10.2%) CABG was performed. Significant differences between groups were detected in heart failure (PCI - 51.2% vs. CABG - 78.6%; = 0.001), previous CABG (11.4% vs. 0%; = 0.014), cardiogenic shock (12.2% vs. 0%; = 0.008). Hospital mortality rate in the PCI group - 10.6%, CABG - 7.1%; = 0.787. A median 3-year survival rate in the PCI group - 66.1%, CABG - 66.7%; = 1.000. Chronic heart failure (OR 2.442; 95% CI: 1.530-3.898, < 0.001), atrial fibrillation (OR 0.425; 95% CI: 0.261-0.692, < 0.001), cardiogenic shock (OR 0.120; 95% CI: 0.054-0.270, = 0.001), and LMCA stenosis (OR 2.104; 95% CI: 1.281-3.456, = 0.003) were identified as independent 3-year all-cause mortality predictors in multivariate regression analysis.
There was no significant difference in hospital mortality and survival rates between elderly patients who underwent PCI or CAGB. The majority of elderly patients underwent a PCI and these patients appeared to experience cardiogenic shock more frequently.
接受侵入性治疗的老年冠心病患者的长期预后数据有限。本研究旨在评估80岁以上接受血运重建治疗患者的长期预后及危险因素。
这项单中心回顾性研究纳入了2012年至2014年间接受冠状动脉造影的≥80岁患者。在590例研究患者中，411例患者有显著的血管造影改变，并接受了经皮冠状动脉介入治疗（PCI）或冠状动脉旁路移植术（CABG）。分析了患者的基线特征，包括人口统计学、合并症、出院存活率和长期死亡率。评估了三年死亡率。
369例（89.8%）患者接受了PCI，42例（10.2%）患者接受了CABG。两组在心力衰竭（PCI组-51.2% vs. CABG组-78.6%；P = 0.001）、既往CABG史（11.4% vs. 0%；P = 0.014）、心源性休克（12.2% vs. 0%；P = 0.008）方面存在显著差异。PCI组的医院死亡率为10.6%，CABG组为7.1%；P = 0.787。PCI组的三年中位生存率为66.1%，CABG组为66.7%；P = 1.000。多因素回归分析确定慢性心力衰竭（OR 2.442；95%CI：1.530 - 3.898，P < 0.001）、心房颤动（OR 0.425；95%CI：0.2
