经皮冠状动脉介入治疗后的30天和1年的临床结果在不同种族和性别之间存在差异

The clinical results of 30 days and 1 year after percutaneous coronary intervention were different among different races and genders

目的:探讨经皮冠状动脉介入术(PCI)治疗的不同性别及种族的冠心病患者术后30 d和1年的预后差异。方法:回顾性分析接受PCI并植入1个药物洗脱支架(DES)或裸金属支架(BMS)的2408例患者的临床资料。其中,黎族男性390例,汉族男性1202例,黎族女性323例,汉族女性493例。随访1年,比较随访30d和1年时不同性别和种族的主要心血管事件(MACE)的发生情况。结果:在冠脉造影及PCI手术特征中,与黎族比较,汉族左主干病变患病率更高,口服替格瑞洛药物的患者比例更多(P均<0.05)。男性患者30 d MACE发生率和死亡率高于女性(P<0.01或P=0.003);汉族30 d MACE发生率、死亡率、靶病变血运重建(TLR)及心肌梗死的30 d发生率低于黎族(P均<0.01或P均<0.05)。1年随访结果显示:男性MACE发生率和死亡率高于女性(P均<0.01);汉族的MACE、TLR、心肌梗死、死亡的1年发生率低于黎族(P均<0.05)。结论:PCI术后的临床结果在不同种族和性别间均存在显著差异。

Objective:To investigate the difference in the prognosis of patients with coronary heart disease(CHD)in different genders and races after percutaneous coronary intervention(PCI)for 30 days and 1 year.Methods:The clinical data of 2408 patients who underwent PCI and implanted a drug-eluting stent(DES)or bare metal stent(BMS)were retrospectively analyzed.Among them,There were 390 Li males,1202 Han males,323 Li females and 493 Han females.Patients were followed up for 1 year,and the occurrence of major cardiovascular events(MACE)in different genders and races at 30 days and 1 year were compared.Results:In the characteristics of coronary angiography and PCI operation,the Han nationality had a higher prevalence of left main lesion and more cases of oral administration of tegrelor drugs in the Li nationality(all P<0.05).The incidence of MACE and death in male patients at 30 days was higher than that in female patients(P<0.01 and P=0.003).The incidence of MACE and death in the Han nationality at 30 days,and the incidence of target lesion revascularization(TLR)and myocardial infarction at 30 days was lower than that in the Li nationality(all P<0.01 and all P<0.05).One-year follow-up results showed that the incidence and mortality of MACE in males were higher than those in females(all P<0.01).The 1-year incidence of MACE,TLR,myocardial infarction and death in Han nationality was lower than that in Li nationality(all P<0.05).Conclusion:The clinical results after PCI are significantly different in races and genders.