Incomplete revascularization in the drug eluting stent era permits meaningful long-term (12-78 months) outcomes in patients ≥ 75 years with acute coronary syndrome  

作　　者：Jie Chen  Qiao Xue  Jing Bai  Lei Gao  Jin-Wen Tian  Ke Li  Qiang Xu  Yan-Hua Li  Yu Wang 

机构地区：[1]Institute of Geriatric Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, 100853 Beijing,China

出　　处：《Journal of Geriatric Cardiology》2012年第4期336-343,共8页老年心脏病学杂志（英文版）

摘　　要：Objective To compare long-term prognosis between complete revascularization (CR) and incomplete revascularization (IR) in elderly patients with acute coronary syndrome (ACS)who underwent percutaneous coronary intervention (PCI). Methods We prospectively enrolled patients ≥75 yearswith ACS and multi-lesion disease between January 2005 andDecember 2010 at our center (Institute ofGeriatric Cardiology, Chinese PLA General Hospital). Baseline clinical characteristics, PCI parameters and long-term (12 to 78 months) outcomes includingmain adverse cardiac and cerebral events (MACCE) were compared betweenCR and IR groups. We used the Kaplan-Meier curve to describe the survival rates, and variables reported to be associated with prognosis were included in Cox regression. Results Of the 502 patients, 230 patients obtained CR, and the other 272 patients underwent IR. Higher SYNTAX score was an independent predictor of IR [Odds ratio (OR): 1.141, 95% confidence interval (95% CI): 1.066–1.221, P = 0.000]. A total of 429 patients (85.5%) were followed with a duration ranging from 12 months to 78 months. There were no significant differences in cumulative survival rates and event free survival rates between the two groups, even for patients with multi-vessel disease. Older age (OR: 1.079, 95% CI: 1.007–1.157, P = 0.032), prior myocardial infarction (OR: 1.440, 95% CI: 1.268–2.723, P = 0.001) and hypertension (OR: 1. 653, 95% CI: 1.010–2.734, P = 0.050) were significant independent predictors of long-term MACCE. Conclusions Given that both clinical and coronary lesion characteristics are much more complex in patients ≥75 years with ACS and multi-lesion disease, IR may be an option allowing low risk hospital results and meaningful long-term (12 to 78months) outcomes.

分 类 号：R5[医药卫生—内科学]