冠状动脉多支病变对急诊经皮冠状动脉介入治疗患者住院期间预后的影响

Impact of multivessel coronary disease on in-hospital outcome in acute coronary syndrome patients undergoing primary percutaneous coronary intervention

目的了解冠状动脉多支病变对急诊经皮冠状动脉介入治疗患者的临床特点及对住院期间预后的影响。方法连续入选接受急诊经皮冠状动脉介入治疗的急性冠状动脉综合征患者。根据冠状动脉造影结果,分为单支病变组35例,多支病变组37例,分析两组临床特点及住院期间心脏不良事件(MACE)的发生情况。结果多支病变组年龄,高血压病,糖尿病,吸烟,入院时血糖,甘油三酯明显高于单支病变组(P<0.05)。且多支病变组术前左心室射血分数低于单支病变组(P=0.001)。与单支病变组比较,多支病变组MACE发生率明显升高(P<0.05)。单因素分析得出,多支病变、糖尿病、入院时血糖、肌酐为MACE事件的危险因素,通过Logistic回归分析,入院时血糖为MACE事件的独立危险因子(OR=1.526,P=0.009)。结论急诊经皮冠状动脉介入治疗患者合并冠状动脉多支病变时,具有多重危险因素,心脏主要不良事件发生率高。

Objective To investigate the clinical characteristics of multivessel coronary disease in acute coronary syndrome patients undergoing primary percutaneous coronary intervention and the impact on in-hospital outcome.Methods This retrospective analysis was performed on 72 patients with ACS undergoing primary PCI.Patients were divided into two groups according to the coronary angiogram:single-vessel group(n =35)and multivessel group(n =37).Results In multivessel group,age,hypertension,diabetes mellitus,smoking,glucose at admission,triacylglyceride were higher than those in single-vessel group(P <0.05).And the left ventricular ejection fraction in multivessel group was lower than that in single-vessel group(P =0.001).Compared with single-vessel group,the incidence of MACE happened more frequently in multivessel group(P <0.05).Conclusion The patients with multivessel coronary disease undergoing primary percutaneous coronary intervention had more risk factors and major adverse cardiac events.