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Objective To analyze the risk factors of repeat revascularization after percutaneous coronary intervention (PCI) in elderly patients.Methods A total of 315 patients,aged 60-99 (72.89±7.80) years hospitalized during 2004 and 2015 due to coronary heart disease and received PCI therapy in the geriatric department of Peking University First Hospital were enrolled.Patients who received repeat revascularization were divided into the target lesion repeat revascularization (TLR)group and the non target lesion revascularization (non-TLR)group.Multivariate regression analysis was performed to make comparisons with non repeat revascularization group respectively and evaluate related risk factors.The median follow-up was 62months.Results The rate of TLR was less than non-TLR in elderly patients.Multivariate regression analysis showed that diabetes mellitus (HR 4.56,95％ CI 1.94-10.75,P＜0.05) and number of stents (HR 1.55,95％ CI 1.05-2.29,P＜0.05) were related risk factor of TLR,while age (HR 0.94,95％ CI 0.90-0.98,P＜0.05),the value of LDL-C reduction (HR 2.51,95％ CI 1.56-3.99,P＜0.05),the proportion of bifurcation lesions (HR 2.24,95％ CI 1.20-4.17,P＜0.05) and residual SYNTAX score (rSS) (HR 1.07,CI95％ 1.02-1.11,P＜0.05) wererelated risk factors of non-TLI.Conclusions The incidence of non-TLR were higher than TLR in elderly patients.Increased total number of stent implantation and diabetes mellitus were related risk factors of TLR,while the lower average age,less reduction of LDL-C,increased proportion of bifurcation lesions and higher rSS were related risk factors of non-TLR.
ABSTRACT
<p><b>OBJECTIVE</b>To identify the impact of age and gender on cardiac structure and left ventricular function in normal Chinese by echocardiography.</p><p><b>METHODS</b>Cardiac structure, valve flow velocity and cardiac function were measured by echocardiography in 15,692 healthy volunteers. Subjects were grouped by age at 5 years interval in population older than 5 years. Children under 5 years were divided into 3 age groups (< 1 years, 1 - 3 years, 4 - 5 years). Hierarchical cluster analyses were performed for ages, based on indexes of cardiac structure and function respectively.</p><p><b>RESULTS</b>Six groups (< 1 years, 1 - 3 years, 4 - 5 years, 6 - 10 years, 11 - 20 years, > or = 21 years) were generated after the age hierarchical cluster analyses based on index of cardiac structure. Four groups (< or = 30 years, 31 - 50 years, 51 - 80 years, > or = 81 years) were generated based on spectral current flow. Six groups (< 1 years, 1 - 3 years, 4 - 5 years, 6 - 10 years, 11 - 15 years, > or = 16 years) were generated based on left ventricular systolic function and five groups (< or = 15 years, 16 - 30 years, 31 - 50 years, 51 - 80 years, > or = 81 years) were generated based on left ventricular diastolic function. Cardiac structure index were similar between male and female in age groups < or = 10 years and significantly lower in females than males in age groups > or = 11 years (P < 0.05). Valve flow velocity was similar between male and female in various age groups (P > 0.05). Left ventricular systolic function was similar between male and female in age groups < or = 10 years but was significantly higher in males than females in age groups > or = 11 years (all P < 0.05). Left ventricular diastolic function was similar between female and male in various age groups (P > 0.05) and equally decreased with aging in both female and male subjects.</p><p><b>CONCLUSIONS</b>The cardiac development in Chinese population can be divided in 6 phases and becomes stable in subjects older than 21 years, left ventricular systolic function becomes stable in subjects older than 16 years and the left ventricular diastolic function declines physiologically with aging.</p>