摘要
目的 评价高龄 (≥ 80岁 )急性心肌梗死 (AMI)患者急诊冠状动脉介入治疗 (PCI)的安全性和近、中期疗效。方法 1999年 9月至 2 0 0 3年 10月收治的行急诊PCI(<12h)的AMI患者中≥80岁的 2 1例 (高龄组 )和 <6 0岁的 37例 (年轻组 ) ,分析两组基础资料特征、即刻手术成功率和随访期间主要不良心血管事件 (复发性心绞痛、心肌梗死及猝死 )发生率的差异。结果 高龄组心力衰竭及多支病变比例高于年轻组 (分别为 71%vs 16 %和 81%vs35 % ,P均 <0 0 5 ) ,高龄组入院至梗死相关动脉开通时间长于年轻组 [(6 3 6± 17 0 )minvs (5 5 3± 13 0 )min ,P <0 0 5 ]。两组患者急诊PCI成功率均为 10 0 %。住院期间死亡高龄组 2例 ,年轻组 0例。随访 4个月至 4年 ,高龄组发生心绞痛 3例、心肌梗死 2例、猝死 0例 (共占 2 4 % ) ;年轻组发生心绞痛 3例、心肌梗死 0例、猝死 0例 (总计 8% ,P <0 0 5 )。结论 高龄AMI患者急诊PCI成功率高 ,入院至梗死相关动脉开通时间延长 ,围手术期死亡和近、中期主要不良心血管事件发生率较高。
Objective To assess the safety and efficacy of recent and mid term outcome of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) over eighty years old Methods Fifty eight patients with AMI (<12 h) underwent primary PCI and were divided into the elder group (≥80 ys, n =21) and the younger group (<60 ys, n =37) The basic characteristics, immediate success rate and major adverse cardiac events (MACE) as recurrent angina, myocardial infarction and sudden cardiac death during follow up were analyzed between two groups Results The ratio of patients with heart failure and multi vessel lesions were higher in the elder group than that in the younger group (71% vs 16% and 81% vs 35%, respectively, P <0 05) Time from adimission to revacularization of infarction related artery (IRA) was longer in the elder group than that in the younger group [(63 6±17 0) min vs (55 3±13 0) min, P <0 05] The immediate success rate of primary PCI was one hundred percent in two groups Two patients died in the elder group and none in the younger group During the follow up period, 3 recurrent angina, 2 MI and no sudden cardiac deeth were reported in the elder group whereas in the younger group, only 3 recurrent angina and no MI and sudden cardiac death were reported The MACE ratio was 24% and 8% in the elder and younger group respectively ( P <0 05) Conclusion The immediate success rate of primary PCI is high in patients with AMI over eighty years old, and it costs longer time to open IRA and has higher ratio of perioperative death, recent and mid term MACE complications
出处
《中国介入心脏病学杂志》
2004年第6期338-340,共3页
Chinese Journal of Interventional Cardiology
