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Objective To assess the safety of PCI and risk of death in ≥85 years old patients.Methods Ninety ≥85 years old coronary heart disease patients after PCI were included in this study.The risk of death on day 30 after PCI and during the follow-up period was assessed according to their surgical access,preoperative and postoperative estimated glomerular filtration rate (eGFR) and bleeding events,NCDR risk score of CHD.The patients were followed up for 693±510 days.Results Eighty-four patients (93.3％) underwent PCI via the radial artery.The dose of contrast media was 128.3±55.8 ml.No significant difference was found in preoperative and postoperative eGFR (55.53 ± 19.58 ml/min · 1.73 m2 vs 55.40± 18.84 ml/min · 1.73 m2,t =0.095,P=0.925).Bleeding occurred in 4 patients (4.4％) with no life-threatening massive bleeding occurred.The risk of death increased in patients with their NCDR risk score ＞45 on day 30 after PCI (P=0.013).Conclusion PCI is a safe and feasible procedure and NCDR risk score can predict the risk of death in ≥85 years old patients on day 30 after PCI.
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Objective To assess the feasibility,safety and efficacy of primary PCI in elderly patients with AMI.Methods Three hundred and sixty-four AMI patients were divided into ≥75 years old group (n=90) and ＜75 years old group (n=274).The successful operation rate,preoperative complication rate,mortality and incidence of major adverse cardiovascular events (MACE) were recorded during their hospital stay time.Results The successful operation rate was 94.4％,the postoperative TIMI 3 blood flow rate was 87.8％,and the preoperative complication rate was 10.0 ％ in ≥75 years old group.The mortality and incidence of MACE were significantly higher in ≥75 years old group than in＜75 years old group during the hospital stay time (12.2％ vs 2.9％,P =0.001;16.7 ％ vs 5.1％,P =0.000).Conclusion Transradial primary PCI is a safe,feasible and effective therapy for ≥75 years old AMI patients.
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Full text of literatures on randomized clinical trials (RCTs) of intracoronary infusion of autologous bone marrow-derived stem cells (BMSCs) transplantation in patients with acute myocardial infarction (AMI) published at home and abroad were systematically retrieved and reviewed from PubMed database and the China Full Text Journal database to assess its efficacy and safety. Fifteen RCTs were included in a recta-analysis with RevMan version 5. 0 software after strict and standard screening. Results showed that global left ventricular ejection fraction (LVEF) in the patients with BMSCs transplantation improved significantly ( P < 0. 01 ), but no obvious change in their left ventricular end-diastolic volume (LVESV) was observed. Occurrence of end-stage cardiovascular events also decreases significantly ( OR =0. 51, 95% CI =0. 36-0. 72) in patients with AMI.