中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2015年
1期
26-30
,共5页
何培源%杨跃进%乔树宾%徐波%姚民%吴永健%袁晋青%陈珏%吴元
何培源%楊躍進%喬樹賓%徐波%姚民%吳永健%袁晉青%陳玨%吳元
하배원%양약진%교수빈%서파%요민%오영건%원진청%진각%오원
血管成形术,经腔,经皮冠状动脉%出血%预后%老年人
血管成形術,經腔,經皮冠狀動脈%齣血%預後%老年人
혈관성형술,경강,경피관상동맥%출혈%예후%노년인
Angioplasty,transluminal,percutaneous coronary%Hemorrhage%Prognosis%Aged
目的 探讨老年冠心病患者经皮冠状动脉介入治疗(PCI)围手术期出血与术后1年主要不良心血管事件的关系.方法 2006年6月至2011年8月,前瞻性纳入在阜外心血管病医院行PCI的老年(≥75岁)冠心病患者1 105例.将患者分为出血组(围手术期发生出血,共153例)和无出血组(围手术期无出血,共952例).利用Cox比例风险回归模型分析出血与术后1年死亡和心肌梗死复合终点的关系.结果 出血学术研究联合会(BARC)2级出血比例为9.5％(105/1 105),≥2级出血比例为11.8％ (130/1 105);穿刺点相关出血占所有出血的62.7％(96/153).出血组术后1年死亡和心肌梗死复合终点事件率高于无出血组[9.2％(14/153)比4.2％(40/952),P=0.008],心原性死亡比例也高于无出血组[3.9％ (6/153)比0.8％(8/952),P=0.007],而非心原性死亡比例两组间差异无统计学意义(P=0.360).Cox比例风险模型分析显示,以无出血为对照,BARC≥2级出血术后1年死亡和心肌梗死复合终点的HR值为2.368(95％ CI:1.201-4.669,P=0.013).结论 PCI围手术期出血是≥75岁冠心病患者术后1年死亡和心肌梗死复合事件的独立危险因素.
目的 探討老年冠心病患者經皮冠狀動脈介入治療(PCI)圍手術期齣血與術後1年主要不良心血管事件的關繫.方法 2006年6月至2011年8月,前瞻性納入在阜外心血管病醫院行PCI的老年(≥75歲)冠心病患者1 105例.將患者分為齣血組(圍手術期髮生齣血,共153例)和無齣血組(圍手術期無齣血,共952例).利用Cox比例風險迴歸模型分析齣血與術後1年死亡和心肌梗死複閤終點的關繫.結果 齣血學術研究聯閤會(BARC)2級齣血比例為9.5％(105/1 105),≥2級齣血比例為11.8％ (130/1 105);穿刺點相關齣血佔所有齣血的62.7％(96/153).齣血組術後1年死亡和心肌梗死複閤終點事件率高于無齣血組[9.2％(14/153)比4.2％(40/952),P=0.008],心原性死亡比例也高于無齣血組[3.9％ (6/153)比0.8％(8/952),P=0.007],而非心原性死亡比例兩組間差異無統計學意義(P=0.360).Cox比例風險模型分析顯示,以無齣血為對照,BARC≥2級齣血術後1年死亡和心肌梗死複閤終點的HR值為2.368(95％ CI:1.201-4.669,P=0.013).結論 PCI圍手術期齣血是≥75歲冠心病患者術後1年死亡和心肌梗死複閤事件的獨立危險因素.
목적 탐토노년관심병환자경피관상동맥개입치료(PCI)위수술기출혈여술후1년주요불양심혈관사건적관계.방법 2006년6월지2011년8월,전첨성납입재부외심혈관병의원행PCI적노년(≥75세)관심병환자1 105례.장환자분위출혈조(위수술기발생출혈,공153례)화무출혈조(위수술기무출혈,공952례).이용Cox비례풍험회귀모형분석출혈여술후1년사망화심기경사복합종점적관계.결과 출혈학술연구연합회(BARC)2급출혈비례위9.5％(105/1 105),≥2급출혈비례위11.8％ (130/1 105);천자점상관출혈점소유출혈적62.7％(96/153).출혈조술후1년사망화심기경사복합종점사건솔고우무출혈조[9.2％(14/153)비4.2％(40/952),P=0.008],심원성사망비례야고우무출혈조[3.9％ (6/153)비0.8％(8/952),P=0.007],이비심원성사망비례량조간차이무통계학의의(P=0.360).Cox비례풍험모형분석현시,이무출혈위대조,BARC≥2급출혈술후1년사망화심기경사복합종점적HR치위2.368(95％ CI:1.201-4.669,P=0.013).결론 PCI위수술기출혈시≥75세관심병환자술후1년사망화심기경사복합사건적독립위험인소.
Objective To evaluate the association between perioperative bleeding post percutaneous coronary intervention(PCI) and 1 year adverse cardiovascular events in elderly patients.Methods From June 2006 to August 2011,1 105 elderly (≥ 75 years) patients undergoing PCI in Fuwai Hospital were prospectively included.Patients were divided into peri-procedure bleeding group (n =153) and no bleeding group (n =952).Cox proportional hazards model was performed to evaluate the independent effect of bleeding on the composite endpoint of death and myocardial infarction.Results BARC 2 grade bleeding occurred in 9.5％ (105/1 105)patients.The rate of BARC ≥2 grade bleeding was 11.8％ (130/1 105),and the access site-related bleeding accounted for 62.7％ (96/153)of all bleeding.The composite endpoint of 1 year death and myocardial infarction was higher in bleeding group (9.2％ (14/153) vs.4.2％ (40/952),P =0.008).The 1 year cardiac death was higher in bleeding group (3.9％ (6/153)vs.0.8％ (8/952),P =0.007),but the rate of non-cardiac death was similar between bleeding group and no bleeding group(P =0.360).Cox proportional hazards model analysis showed that HR of 1 year death and myocardial infarction in BARC ≥2 grade bleeding patients was 2.368 (95％ CI:1.201-4.669,P =0.013) compared with no bleeding patients.Conclusion Perioperative bleeding post PCI is an independent predictor of 1 year adverse outcomes in elderly patients(≥75 years).
