左心室收缩功能变化对冠心病患者PCI术后临床结局的影响

The impact of left ventricle systolic function on clinical outcome of coronary heart disease patients after PCI

目的探讨左心室收缩功能变化对冠心病患者经皮冠状动脉支架植入术(PCI)后临床结局的影响。方法采用回顾性队列研究的方法,入选2012年1月-2016年12月期间于新疆医科大学第一附属医院心脏中心经冠状动脉造影术确诊为冠心病并行PCI的患者共5 684例,按照PCI术前左心室射血分数(LVEF)将患者分为左心室收缩功能正常组共5 152例(LVEF≥50%)和左心室收缩功能不全组共532例(LVEF<50%),比较2组患者术后主要心血管不良事件(MACE)的发生率,采用多因素COX回归分析法评估LVEF与冠心病患者PCI术后心血管不良事件发生率之间的关系及其影响因素。结果左心室收缩功能不全组发生MACE事件200例(37.5%),发生率明显高于左心室收缩功能正常组(28.3%),差异有统计学意义(P <0.05)。COX回归分析显示,在调整了其他危险因素的干扰后,差异仍然有统计学意义(P <0.05)。结论左心室收缩功能不全是冠心病患者PCI术后不良事件的独立预测因素。

Objective To explore the change of left ventricle systolic function on clinical outcome of coronary heart disease(CHD)patients after PCI.Methods With the method of retrospective cohort study,a total of 5 684 patients who were diagnosed as CHD through coronary angiography and received coronary stent implantation in Heart Center of The First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2016 were screened.Based on the left ventricular ejection fraction(LVEF)before Percutaneous transluminal coronary intervention(PCI),the patients were divided into one group of 5152 with normal left ventricular systolic function(LVEF≥50%)and the other group of 532 with left ventricular systolic dysfunction(LVEF<50%).The occurrence rate of major adverse cardiovascular events(MACE)after PCI of the two groups was compared.The relation between LVEF and the occurrence rate of MACE after PCI,and the factors were also assessed with regression analysis method of multivariate COX.Results The cases of MACE for the group with left ventricular systolic dysfunction were 200(37.5%),apparently higher than that of the group with normal left ventricular systolic function(28.3%),and the difference was statistical significance(P<0.05).COX regression analysis showed that the difference was also statistically significant even after excluding other risk factors(P<0.05).Conclusion Left ventricular systolic dysfunction is the independent predictive factor on MACE happening for coronary heart disease patients after PCI.