Comparing different revascularization approaches on the prognosis of elderly patients aged 75 and over with diabetes and multi-vessel coronary artery disease
10.3760/cma.j.issn.0254-9026.2016.02.009
- VernacularTitle:不同血运重建策略对年龄75岁及以上冠状动脉多支病变伴糖尿病患者预后影响的对比研究
- Author:
Hailong GE
;
Dongmei SHI
;
Yonghe GUO
;
Wanjun CHENG
;
Lixia YANG
;
Yingxin ZHAO
;
Yujie ZHOU
- Publication Type:Journal Article
- Keywords:
Angioplasty,transluminal,percutaneous coronary;
Coronary artery bypass;
Diabete mellitus
- From:
Chinese Journal of Geriatrics
2016;35(2):147-150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical effects of two different revascularization approaches,one via percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and the other via coronary artery bypass graft (CABG),on short-and long-term prognosis in elderly patients with diabetes and multi-vessel coronary artery disease.Methods A retrospective analysis was conducted on 254 elderly patients with diabetes and multi-vessel coronary artery disease.Based on the revascularization approach,patients were divided into the PCI group (n=93) and the CABG group (n =161).The incidence of major cardiovascular events (MACE) were observed during hospitalization and 1-year after follow-up.Results All-cause mortality and the incidence of non-fatal myocardial infarction were higher in the CABG group than in the PCI group during hospitalization [4.9％ (8 cases) vs.1.1％ (1 cases),5.6％ (9 cases) vs.2.2％ (2 cases),each P＜0.05],while there was no significant difference in the incidence of MACE between the two groups1-year after follow-up (P＞ 0.05).The incidence of cerebrovascular events was lower in the PCI group than in the CABG group [2.2 ％ (2 cases) vs.6.2％ (10 cases),P＜0.05],while the rate of revascularization was higher in thePCI group than in the CABG group [6.5％ (6 cases) vs.1.9％ (3 cases),P＜0.05].Cox regression analysis showed that diabetes (OR =1.65,95％ CI:1.013-1.926,P =0.024) and left ventricular ejection fraction (OR =1.30,95 ％ CI:1.018-1.652,P =0.027) were independent risk factors for revascularization and cerebrovascular events.Conclusions MACEs during hospitalization are fewer in elderly patients with diabetes and multi-vessel coronary artery heart disease who received PCI than in those who received CABG.PCI has a similar mid-and long-term effect as CABG,bur PCI has a higher revascularization rate and lower risk of MACEs than CABG.
