老年患者经皮冠状动脉介入治疗:来自发展中国家三级保健中心的经验

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摘要

目的:评价老年人经皮冠状动脉介入治疗的成功率和并发症。方法:回顾性分析卡拉奇心脏病研究所2015-2020年连续887例经皮介入治疗的资料。我们将患者分为三个年龄较小的组(75岁,n=94)。比较两组患者住院血管并发症、死亡、心肌梗死、重复靶区血管重建术和卒中的即时和6个月预后。结果:三组患者血管并发症发生率分别为3.2%、2.9%、4.3%,p=0.56。老年/老年患者围手术期心肌梗死的相对风险不高于年轻患者(OR为0.6,95% CI为0.3 vs . 1.4, P=0.35),需要重复靶血运重建的患者(OR为0.3,95% CI为0.2 vs . -1.6, P=0.85),手术后卒中的风险最小(OR为0.7,95% CI为0.4 vs . 1.6 P=0.4)。三组老年人住院死亡率均较高(95% CI 1.0 vs 2.0 vs 3.4 P=0.03)。老年患者心肌梗死6个月预后也不高于年轻患者(OR 0.7 vs 0.4 P=0.58)。重复目标血运重建术的需要也同样如此(OR 0.5 vs 0.3 P=0.6)。三组老年人6个月死亡率均较高(OR为95% CI 1.5% vs 3.4% vs 4%, P值为0.04)。结论:老年患者的手术成功率与年轻患者相似,但住院和6个月死亡率较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Percutaneous Coronary Interventions in Elderly Patients: Experience from a Tertiary Care Center from Developing Country
Objective of the study: To assess the outcome of Percutaneous coronary intervention in elderly in terms of success and complications. Methods: Retrospective data review of 887 consecutive cases of percutaneous interventions done at Karachi institute of heart diseases from 2015-2020. We divided the patients in three age groups younger (<65 years, n=592); older (65 to 75 years, n=201); and elderly (>=75 years, n=94). Immediate and six months outcomes of in hospital vascular complications, death, myocardial infarction, repeat target lesion revascularization and stroke were compared between these groups. Result: The vascular complications was in three groups (relative risk 3.2% vs 2.9% vs 4.3% with p=0.56) respectively. The relative risk of periprocedural Myocardial infarction in elderly/older patients was not higher than young patients with (OR of 0.6 with 95% CI 0.3 vs 1.4 with P=0.35), so was the need of repeat target revascularization with (OR of 0.3 95% CI 0.2 vs -1.6 with P=0.85), the risk of stroke following procedure was minimal (OR of 0.7 95% CI 0.4 vs 1.6 P=0.4). The in-hospital mortality was higher in elderly with (OR with 95% CI 1.0 vs 2.0 vs 3.4 P=0.03) in three groups. The six months outcomes of myocardial infarction in elderly were also not higher than younger pts (OR 0.7 vs 0.4 P=0.58). so was the need for repeat target revascularization (OR 0.5 vs 0.3 P=0.6). The six-month mortality in three groups was high in elderly (OR with 95% CI 1.5% vs 3.4% vs 4% with P value of 0.04). Conclusion: The procedure success in elderly patients was similar to younger patients, but in hospital and six months mortality was higher in elderlies.
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