不同性别急性冠状动脉综合征合并癌症患者PCI术后预后及危险因素分析

Analysis of Clinical Prognosis and Risk Factors in Patients with Acute Coronary Syndrome and Cancer After PCI in Different Genders

目的 探讨不同性别急性冠状动脉综合征(ACS)合并癌症患者冠状动脉介入治疗(PCI)术后的预后。方法 回顾性分析415例ACS患者的临床资料,均行PCI治疗。分别收集男性与女性患者一般资料,并于术后随访3年,记录其生存情况、不良心脑血管事件(MACCE)发生率及出血事件发生率。分析不同性别ACS合并癌症患者的临床特征及临床预后,并经Logistic回归分析获取影响男性、女性ACS合并癌症患者全因死亡的独立危险因素。结果 男性ACS合并癌症患者年龄、高血压、糖尿病、既往PCI史、血红蛋白、LVEF与未合并癌症患者相比,差异有统计学意义(P<0.05);女性ACS合并癌症患者高血压、糖尿病、既往PCI史、血红蛋白及LVEF与未合并癌症组相比,差异有统计学意义(P<0.05);男性ACS合并癌症患者全因死亡率、MACCE发生率及出血事件发生率高于未合并癌症者,差异有统计学意义(P<0.05);女性ACS合并癌症患者MACCE发生率高于未合并癌症组,差异有统计学意义(P<0.05);多因素分析显示,年龄、癌症病史、血红蛋白为影响男性ACS患者全因死亡的独立危险因素(P<0.05);血红蛋白、LVEF为影响女性ACS患者全因死亡的独立危险因素(P<0.05)。结论 ACS合并癌症患者PCI术后预后差,更易发生死亡、MACCE及出血事件,且癌症为男性患者全因死亡的独立危险因素。

Objective To investigate the clinical prognosis of patients with acute coronary syndrome(ACS) and cancer after coronary intervention(PCI) in different gender.Methods Clinical data of 415 patients with ACS were retrospectively analyzed, all of whom were treated with PCI.The general data of male and female patients were collected and followed up for 3 years.Their survival, the incidence of adverse cardiovascular and cerebrovascular events(MACCE) and the incidence of bleeding events were recorded.The clinical characteristics and prognosis of ACS with cancer were analyzed, and the independent risk factors of all-cause death in male and female patients were obtained by logistic regression analysis.Results There were significant differences in age, hypertension, diabetes, previous PCI history, hemoglobin and LVEF between male ACS patients with cancer and those without cancer(P<0.05);There were significant differences in hypertension, diabetes, previous PCI history, hemoglobin and LVEF between female ACS patients with cancer and those without cancer(P<0.05);The all-cause mortality, the incidence of MACCE and the incidence of bleeding events in male ACS patients with cancer were significantly higher than those in the non cancer group(P<0.05);The incidence of MACCE in female ACS patients with cancer was higher than that in the group without cancer, and the difference was statistically significant(P<0.05);Multivariate analysis showed that age, cancer history and hemoglobin were independent risk factors for all-cause death in male ACS patients(P<0.05);Hemoglobin and LVEF were independent risk factors for all-cause death in female patients with ACS(P<0.05).Conclusion ACS patients with cancer are more prone to death, MACCE and bleeding after PCI,and cancer is an independent risk factor for all-cause death in male patients.