摘要
目的:评价贫血对老年急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后预后的影响。方法:入选2010-06至2012-06接受单纯PCI术的老年(年龄>60岁)ACS患者908例,根据世界卫生组织对贫血的定义(血红蛋白女性<12.0 g/dl、男性<13.0 g/dl)将患者分为贫血组(283例)和非贫血组(625例),比较两组患者的临床特征。PCI术后对患者进行1年的随访,比较两组患者的病死率和主要心脑血管不良事件(MACCE:包括心原性死亡、心肌再梗死、心功能恶化、靶血管再次血运重建、脑出血、脑梗死)的发生率。结果:31%的老年ACS患者患有贫血。贫血组的ACS患者高龄、女性、糖尿病、高血压、慢性肾功能不全、射血分数降低以及三支血管病变的比例明显高于非贫血组(P<0.05)。PCI术后1年的病死率和MACCE发生率明显高于非贫血组(P<0.05)。多因素回归分析显示,贫血是老年ACS患者PCI术后1年病死率的一个独立预测因素(P<0.05)。结论 :贫血可增加老年ACS患者PCI术后长期的总死亡率和MACCE。
Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI).Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO definition of anemia(HB12.0 g/d L in female and HB13.0 g/d L in male), the patients were classified as Anemia group, n=283 and Non-anemia group, n=625. The patients were followed-up for 1 year. The basic clinical characteristics, incidences of mortality and major adverse cardiovascular and cerebravascular events(MACCE) were compared between 2 groups by cardiac death, myocardial re-infarction, worsening of cardiac function, target vessel revascularization, cerebral hemorrhage and cerebral infarction.Results: There were 31% of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P0.05. Multiple regression analysis indicated that anemia is the independent predictor for mortality in elder ACS patients at 1 year after PCI, P0.05.Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.
出处
《中国循环杂志》
CSCD
北大核心
2014年第12期968-971,共4页
Chinese Circulation Journal