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As population aging continues,it has become increasingly common to encounter patients of advanced age with coronary artery disease(CAD).Consequently,clinicians often face the issue of how to provide safe and effective treatment for patients of advanced age with non-ST segment elevation acute coronary syndrome.This article reviews recent advances in this field.
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Objective:To explore the value of two-dimensional speckle tracking echocardiographic imaging (2D-STI) for assessing partial and global left ventricular functional changes at pre-and post-percutaneous coronary intervention (PCI) in patients with chronic total coronary occlusion. Methods:Echocardiograph was conducted in 23 chronic total coronary occlusion patients at pre-PCI and 1 day, 3, 6 months post-PCI to examine left ventricular ejection fraction (LVEF), meanwhile 2D-STI was applied to obtain the global longitudinal strain (GLS) value of left ventricle. Results:In all 23 patients, for LVEF, compared with pre-PCI (59.29±12.15)%, it was increased at 3 and 6 months post-PCI (60.00±12.35)%and (61.37±11.8)%respectively, all P Conclusion:PCI could effectively improve left ventricular function in patients with chronic total coronary occlusion, 2D-STI technology may quantitatively assess those changes at the early stage.
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Objective To compare the predicting values for Prognosis among Global Risk Classification (GRS),Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) score,the European System for Cardiac Operative Risk Evaluation (EuroSCORE) in patients who received stenting because of unprotected left main coronary artery (ULMCA) lesion.Methods Totally 105 successive elderly patients with ULMCA lesion who received stenting were divided into 2 groups:with and without main adverse cardiac events (MACE).The clinical and angiographic characteristics were analyzed and then compared among GRC,SYNTAX score and EuroSCORE.Results As compared with none MACE group,MACE group had higher EuroSCORE score (2.0±2.3 vs.6.5±2.9,t=8.18,P=0.002),and more trivessel disease and left main bifurcation lesion (x2 =8.96,6.96,P =0.011,P =0.008).High risk GRC showed more MACE than medium or low risk GRC [55.9％ (19/34) vs.20.5％(9/44),7.4％ (2/27),x2 =19.77,P=0.001].AUC(95％CI )of GRC,SYNTAX score and EuroSCORE were [0.821 (0.730-0.912),0.586(0.462-0.709) and 0.631 (0506-0.757)],respectively.Compared with SYNTAX score and EuroSCORE,GRC was superior in the MACE predicting value (Z=3.29,2.63,P＜0.01 or P＜0.05).