绝经对经皮冠状动脉介入治疗冠心病影响分析

The impact of menopausal female patients with coronary artery disease underwent coronary artery intervention

目的探讨绝经对经皮冠状动脉介入治疗冠心病的影响。方法选取2010年1月至2014年12月首次行冠状动脉造影提示冠状动脉病变并行经皮冠状动脉介入治疗(PCI)的绝经女性患者10 746例,分为A组(绝经时间>5年,n=5 573)与B组(绝经时间≤5年,n=5 173)。记录随访期间的主要心脑血管不良事件、死亡、靶血管再次血运重建、出血事件等发生率。采用多因素Logistic回归分析患者死亡的影响因素。结果 A组随访30 d及1年的主要心脑血管不良事件、死亡发生率均高于B组(P<0.05)。多因素Logistic回归分析显示,病变血管支数、肾小球滤过率是影响A组患者死亡的独立危险因素。结论绝经时间>5年的女性患者行PCI治疗冠心病预后差于绝经时间≤5年的女性,病变血管支数、肾小球滤过率是其死亡的独立危险因素。

Objective To investigate the effects of menopause age on prognosis in menopaus women after percutaneous coronary inter- vention （PCI）. Methods From January 2010 to December 2014,10 746 cases of menopausal women with ACS who underwent PCI were enrolled. Patients were divided into Group A（ women whose menopause lasted more than 5 years, n = 5 573 ） and Group B （women whose menopause lasted 5 years or less, n = 5 173 ）. Endpoints included the major adverse cardiac and cerebral events （MACCE）, mortality, target vessd revaseularization （TVR） and bleeding events. Multifaetor logistic regression analysis was used to analyze the fac- tors affecting the death of patients. Results Both MACCE events and mortality in Group A were higher than those in Group B at 30 days and 1 year（P 〈 O. 05 ）. In the multivariate logistic regression analysis, the number of lesion coronary arteries, glomerular filtration rate （GFR） were independently correlated with the mortality in women whose menopause lasted more 5 years with ACS patients under- went PCI. Conclusion In ACS women whose menopause lasted more than 5 years underwent PCI have higher long-term total mortality and MACCE than in women whose menopause lasted 5 years or less. The number of lesion coronary arteries, GFR are independent risk factor influenced on menopausal more than 5 years group.