高龄急性ST段抬高型心肌梗死患者临床特点的分析

Clinical characterristics of very old patients with acute ST segment elevation myocardial infarction

目的了解行介入治疗的高龄急性ST段抬高型心肌梗死患者的临床特点及预后。方法入选2010年1月1日~2014年12月31日入住中国医科大学附属盛京医院心内科确诊为急性ST段抬高型心肌梗死,且行介入治疗的老年患者604例,依据年龄分为老年组(60~79岁)524例和高龄组(≥80岁)80例,收集患者临床基本资料、冠状动脉造影及介入结果、术后出院带药情况,记录终点事件,回顾性分析2组患者临床特点及预后差异。结果与老年组比较,高龄组术后血流TIMI 3级比例更低(96.3%vs 99.0%)、平均支架长度更短(31mmvs 38mm)、男性、吸烟、术后应用氯吡格雷、β受体阻滞剂比例降低(P<0.05)。2组术后主要不良心血管事件发生率比较,差异无统计学意义(17.6%vs 21.3%,P>0.05)。结论高龄急性ST段抬高型心肌梗死患者具有独特的临床特点,其术后主要不良心血管事件发生率与老年患者无显著差异。

Objective To study the clinical characteristics and outcome of very old patients with acute ST-segment elevation myocardial infarction（STEMI）after PCI.Methods Six hundred and four elderly STEMI patients admitted to our hospital from 2010-01-01 to 2014-10-01 were divided into 60-79 years old group（n=524）and≥80years old group（n=80）.Their general data,coronary angiographic data,PCI data,and end-point events were recorded.Their clinical characteristics and outcome were retrospectively analyzed.Results The incidence of TIMI 3was lower and the average stent length was shorter in ≥80years old group than in 60-79 years old group（96.3%vs 99.0%,31 mmvs 38 mm,P〈0.05）.The number of males,cigaret smokers,clopidogrel andβ-blocker users was smaller after PCI.No significant difference was found in MACE between the two groups（17.6% vs 21.3%,P〉0.05）.Conclusion ≥80years old STEMI patients are of their unique clinical characteristics.The incidence of MACE is not significantly different in ≥80years old STEMI patients and 60-79 years old STEMI patients.