Prognosis and potential modifying factors of coronary artery disease in the elderly with percutaneous coronary intervention
ZHOU Xue-zhong1, WANG Hui1, LUO Tai-yang2
（1. Department of Cardiology, the First People′s Hospital of Changzhou,Changzhou Jiangsu 213000； 2. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China）
Abstract：Objective: To investigate the factors affecting the prognosis of coronary artery disease(CAD) in the elderly group(≥65 years old) with percutaneous coronary intervention (PCI). Methods: A total of 3 473 patients with PCI were enrolled in this study. Patients were divided into two groups according to age,the elderly group(≥65 years old, n=2 005) and the control group(<65 years old, n=1 468). The mean time of follow-up was 577 days. We investigated the differences of the total mortality rate and major adverse cardiac cerebral vessels events(MACCE) between the two groups and analyze the factors which affect the prognosis of CAD. Results: The total mortality rate(3.6% vs 1.5%，P<0.001) and MACCE (12.3% vs 3.3%, P<0.001)were significantly higher in the elderly group than those of control group. Compared to the control group, the prevalence of hypertension，diabetes mellitus(DM), cerebrovascular disease, old myocardial infarction and complete revascularization rate in the elderly group were significantly higher.Coronary lesions were more serious,the incidence of STsegment elevated myocardial infarction(STEMI), triple vessel lesions, left main lesions and chronic total occlusion were higher in the eldly group,while endogenous creatinine clearance was significantly lower than the control group. Multivariate Cox regression analysis showed that the risk factors affecting the total mortality rate of CAD in the elderly with PCI were as follow: DM(HR:1.857, 95% CI:1.121-3.142, P=0.012) ,history of old myocardial infarction(HR：2.211, 95% CI：1.113-4.112, P=0.015), triple vessel injury(HR：1.751, 95% CI：1.135-2.653, P=0.006) and the elderly age (HR：4.585, 95% CI：2.013-9.201, P<0.001),those affecting the MACCE were creatinine clearance(HR：1.975, 95% CI:1.101-3.215, P<0.001)，left main disease(HR：1.976, 95% CI:1.173-2.874, P<0.001) , and triple vessel injury(HR:1.573, 95% CI:1.263-1.886, P<0.001). Conclusion: The risk factors affecting the total mortality of CAD in the elderly with PCI were DM and old myocardial infarction, triple vessel injury and the elderly age, those affecting the MACCE were left main disease, creatinine clearance and triple vessel injury.
［Key words］elderly; coronary artery disease; percutaneous coronary intervention; prognosis
2018, Vol. 28 
