不同年龄段STEMI患者PCI治疗后住院期间短期预后效果与MACE发生率的差异性分析

Difference of major adverse cardiovascular events incidence and in-hospital short-term prognosis after PCI between different aged patients with STEMI

目的探讨不同年龄段ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后住院期间短期预后效果与主要不良心血管事件(major adverse cardiovascular events,MACE)发生率的差异性分析。方法选取2015年10月至2016年10月在解放军八五医院住院治疗的STEMI患者178例,根据年龄的差异分为老年组(114例,年龄≥60岁)和非老年组(64例,年龄<60岁),比较两组的一般临床资料、心功能参数[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室缩短分数(left ventricular fractional shortening,LVFS)和每搏输出量(stroke volume,SV)]及MACE发生率,并应用Logistic回归模型分析影响STEMI患者MACE发生率的因素。结果两组在病变血管支数和年龄上相比,差异具有统计学意义(P<0.05);治疗前,两组LVEF、LVFS和SV相比,差异无统计学意义(P>0.05)。治疗后,老年组LVEF、LVFS和SV均显著低于非老年组,差异具有统计学意义(P<0.05);老年组MACE发生率高于非老年组,差异具有统计学意义[26.32%(30/114)vs.12.50%(8/64),P<0.05]。Logistic回归模型结果显示,年龄(OR=3.387,95%CI:2.329~7.024)和病变血管支数(OR=2.436,95%CI:2.610~5.168)是影响STE-MI患者发生MACE的因素(P<0.05)。结论老年STEMI患者PCI治疗后住院期间的短期预后效果较差、MACE发生率较高。年龄是STEMI患者发生MACE的主要危险因素之一。

Objectives To investigate the difference of major adverse cardiovascular events(MACE)incidence and in-hospital short-term prognosis after percutaneous coronary intervention(PCI)between different aged patients with ST-segment elevation myocardial infarction(STEMI)Methods Totally 178 patients with STEMI were collected from October 2015 to October 2016 in The 85th Hospital of PLA.According to the difference of age,the patients were divided into elder group(114 cases,age≥60)and non-elder group(64 cases,age<60).General clinical data,cardiac function parameters[left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),stroke volume(SV)]and incidence of MACE between the two groups were compared.Factors affecting incidence of MACE were analyzed by Logistic regression model.Results Lesion vessel number and age between the two groups were statistically significant(P<0.05).Before treatment,LVEF,LVFS and SV of the two groups had no statistical significance(P>0.05).After treatment,LVEF,LVFS and SV of elder group were significantly lower than those of nonelder group(P<0.05).Incidence of MACE in elder group was significantly higher than that in non-elder group[26.32%(30/114)vs.12.50%(8/64),P<0.05)].Logistic regression model results showed that age(OR=3.387,95%CI:2.329-7.024)and lesion vessel number(OR=2.436,95%CI:2.610-5.168)were the influencing factors of MACE incidence in patients with STEMI(P<0.05).Conclusions Short-term prognosis is poor and MACE incidence is high for inhospital elder patients with STEMI after PCI.Age is one of the main risk factors for incidence of MACE in patients with STEMI.