经皮介入治疗慢性冠状动脉完全闭塞性病变合并心肌梗死的预后因素分析

Prognostic factors of percutaneous coronary intervention for chronic total occlusion and myocardial infarction

目的分析经皮介入治疗(PCI)慢性冠状动脉完全闭塞性(CTO)病变合并心肌梗死(MI)的预后因素。方法 82例PCI治疗CTO患者,其中32例为CTO合并MI(合并组),50例仅为CTO(不合并组)。平均随访6个月,Logistic多因素回归分析预后因素。结果合并组的糖尿病、高血脂、高血压、心源性休克及不良心血管事件发生率高于不合并组(P<0.05),而左室射血分数、术后TIMI血流3级低于不合并组(P<0.01)。糖尿病、高血脂、心源性休克及术后TIMI血流3级为独立危险因素。结论糖尿病、高血脂、心源性休克及术后TIMI血流3级是PCI治疗CTO合并MI患者的独立危险因素。

Objective To analyze the prognostic factors of percutaneous coronary intervention（PCI） for chronic total occlusion（CTO） and myocardial infarction（MI）. Methods Thirty-two patients with CTO and MI and 50 CTO cases were treated with PCI and followed up for an average of 6 months. The prognostic factors were performed by multifactorial logistic regression analysis. Results Compared with CTO cases, diabetes mellitus, hyperlipidemia, hypertension, cardiogenic shock,and major adverse cardiovascular events were higher（P〈0.05）, while left ventricular ejection fraction and postoperative TIMI grade 3 were lower（P〈0.01） in patients with CTO and MI. The diabetes mellitus, hyperlipidemia, cardiogenic shock and postoperative TIMI grade 3 were independent risk factors. Conclusion The diabetes mellitus, hyperlipidemia, cardiogenic shock and postoperative TIMI grade 3 are the independent risk factors for patients with CTO and MI undergoing PCI.