老年急性心肌梗死直接冠状动脉腔内成形术疗效

Effects of primary percutaneous transluminal coronary angioplasty in aged patients with acute myocardial infarction

目的通过65岁以上急性心肌梗死(AMI)患者直接经皮冠状动脉腔内成形术(PTCA)的临床分析为老年AMI患者的治疗提供参考。方法连续行直接PTCA的AMI患者共139例,根据年龄分成≥65岁和<65岁2年龄组,比较其在院主要并发症的发生率及病死率。结果在临床特征及冠状动脉病变特点方面,随年龄老化,不利因素显著增加。在院期间主要并发症发生率,2组间差异有显著性(P<0.05);在院期间病死率,≥65岁组为16%,<65岁组为4%,差异有显著性(P<0.05)。结论65岁以上老年患者直接PTCA有较高的恶性心脏事件发生率及病死率。在院期间PTCA预后与年龄密切相关。合并心源性休克可能是AMI患者直接PTCA的主要死亡原因。

Objective To evaluate the outcome of the 65 years or older patients with acute myocardial infarction (AMI) treated by primary percutaneous translum inal coronary angioplasty (PTCA) for providing reference in the treatment. Metho ds The 37 elderly patients over 65 years old and, the 102 patients under 65 yea rs old who suffered from AMI and underwent primary PTCA were divided into two gr oups. The baseline clinical characteristics, coronary angiogram and major cardio vascular events were analysed. Results The patients 65 years of age or older ha d more adverse baseline characteristics and coronary angiogram than the young on es. The serious complications incidence and mortality rate of elderly patients o ver 65 years old was significantly higher than that of relevant groups(P<0.05). Conclusion The mortality and incidence of malignant events associated with PTC A for AMI in the elderly remains high. The in-hospital outcomes following a succ essful angioplasty are related with age; complicated cardiogenesis shock would b e a main cause of death following primary PTCA.