Therapeutic effect of PCI on patients with coronary chronic total occlusion and its influencing factors
10.3969/j.issn.1008-0074.2015.01.12
- VernacularTitle:冠脉慢性完全闭塞患者行 PCI 的疗效及其影响因素
- Author:
Zhongdao ZHANG
- Publication Type:Journal Article
- Keywords:
Coronary occlusion;
Angioplasty,balloon,coronary;
Treatment outcome
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2015;24(1):42-46
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the therapeutic effect of percutaneous coronary intervention (PCI)on patients with coronary chronic total occlusion (CTO),and its influencing factors.Methods:A total of 96 patients,who were di-agnosed as CTO by coronary angiography in our hospital from Dec 2009 to Jan 2014,were divided into PCI group (n=75)and routine treatment group (n = 21 ).Therapeutic effect of PCI,changes of levels of creatine kinase isoenzyme (CK-MB),cardiac troponin T (cTnT)and N terminal pro brain natriuretic peptide (NT-proBNP),and echocardiographic change before and after treatment were observed in two groups,and its influencing factors were analyzed.Results:After PCI,CTO was successfully opened in 64 cases (85.3%)among the 75 CTO cases.On one week after treatment,levels of CK-MB,cTnT and NT-proBNP significantly reduced in both groups compared with before treatment (P <0.05 or <0.01);compared with routine treatment group after treatment,there were signifi-cant reductions in levels of CK-MB [(16.28±4.12)U/L vs.(14.26±7.12)U/L],cTnT [(0.32±0.14)ng/ml vs. (0.22±0.12)ng/ml]and NT-proBNP [(1029.27±332.86)pg/ml vs.(879.73±332.86)pg/ml]in PCI group (P<0.05 or <0.01).After three-month treatment,echocardiography indicated that compared with routine treatment group,there were significant reductions in left ventricular end-diastolic volume index [LVEDVI,(79.4±20.1)ml/m2 vs.(68.2±22.4)ml/m2 ]and left ventricular end-systolic volume index [LVESVI,(49.1 ± 17.2)ml/m2 vs. (39.2±16.3)ml/m2 ],and significant rise in left ventricular ejection fraction [LVEF,(44.2±8.0)% vs.(46.8± 8.2)%]in PCI group,P <0.05 all;multi-factor gradual Logistic regression analysis indicated that chest pain time>three years,medical history of myocardial infarction,complicated three-vessel disease and target vessel opening occlusion were independent risk factors influencing therapeutic effects on CTO (OR=0.442~0.992,P <0.01 all). Conclusion:PCI can improve coronary artery perfusion,heart function and ventricular remodeling in CTO patients. Chest pain time,medical history of myocardial infarction,three-vessel disease and target vessel opening occlusion are independent risk predictors influencing therapeutic effects on CTO,which need attention.
