冠状动脉旋磨术对老年冠心病合并冠状动脉钙化患者的疗效及安全性分析

Efficacy and safety of coronary rotational atherectomy in elderly patients with coronary heart disease and coronary artery calcification

目的探讨老年冠心病合并冠状动脉钙化患者采用冠状动脉旋磨术的治疗效果。方法选取该院2021年1-12月收治的老年冠心病合并冠状动脉钙化患者104例,根据是否行冠状动脉旋磨术分为对照组(54例,采用常规介入治疗)、观察组(50例,在常规介入基础上行冠状动脉旋磨术),比较两组患者治疗前后心脏射血分数(EF)、靶血管管腔直径、术后并发症情况以及术后12个月主要不良心血管事件(MACE)发生率。结果两组患者吸烟史、高血压、糖尿病、术前心脏射血分数、术前靶血管管腔直径比较,差异均无统计学意义(P>0.05),术后观察组患者心脏射血分数、靶血管管腔直径明显优于对照组(P<0.05);术后两组患者并发症(冠状动脉夹层、穿孔、冠状动脉慢血流、心律失常)发生率无明显差异(P>0.05);术后12个月两组患者MACE事件(心源性死亡、非致死性心梗、支架内血栓形成、靶血管血运重建)发生率无明显差异(P>0.05)。结论针对老年冠心病合冠状动脉钙化患者,冠状动脉旋磨术治疗能有效改善患者冠状动脉狭窄和心功能,安全性较高,值得临床广泛应用。

Objective To investigate the therapeutic effect of coronary rotational atherectomy on elderly patients with coronary heart disease and coronary artery calcification.Methods A total of 104 elderly patients with coronary heart disease and coronary artery calcification who were admitted to our hospital from January to December 2021 were enrolled,and according to whether coronary rotational atherectomy was performed,they were divided into control group(54 patients receiving conventional interventional therapy)and observation group(50 patients receiving coronary rotational atherectomy in addition to conventional interventional therapy).The two groups were compared in terms of cardiac ejection fraction(EF)and target vessel lumen diameter before and after treatment,postoperative complications,and the incidence rate of major adverse cardiovascular events(MACE)at 12 months after surgery.Results There were no significant differences between the two groups in age,sex,smoking history,hypertension,diabetes mellitus,cardiac EF,and target vessel lumen diameter(P>0.05),and after surgery,the observation group had significantly better cardiac EF and target vessel lumen diameter than the control group(P<0.05).There were no significant differences between the two groups in the incidence rates of postoperative complications(coronary artery dissection,perforation,coronary slow flow,and arrhythmia)(P>0.05),and there were also no significant differences between the two groups in the incidence rates of MACE events(cardiac death,nonfatal myocardial infarction,stent thrombosis,and target vessel revascularization)at 12 months after surgery(P>0.05).Conclusion For the elderly patients with coronary heart disease and coronary artery calcification,coronary rotational atherectomy can effectively improve coronary artery stenosis and cardiac function with a favorable safety profile,and therefore,it holds promise for wide clinical application.