Prognosis and Risk Factors of PCI-treated Senile Patients with Unprotected Left Main Coronary Artery Disease: A Follow-up Study / 医学研究杂志

ABSTRACT

Objective To study the prognosis and risk factors of senile patients with unprotected left main coronary artery (ULMCA) disease treated with PCI.Methods Patients with ULMCA undergoing PCI from a single center were enrolled in the study.All patients were older than 60.The baseline characteristics were collected and the prognosis and risk factors of the patients were followed-up.All the major adverse cardiovascular and cerebrovascular events (MACCE) were evaluated throughout the follow-up period.Based on those data,Kaplan-Meier curves were plotted and Cox multivariate regression analysis was performed to assess the prognosis and identify risk factors.Results A total of 182 consecutive patients were recruited and followed up with a mean follow-up time of 21.5 (13,36.5) months and an estimated median MACCE-free survival time of 66 months by K-M method.During the follow up,all-cause mortality,non-fatal myocardial infarction,non-fatal cerebrovascular events and target vessel revascularization rates were 6.59％,0.55％,0.55％ and 15.93％ respectively,the incidence of all MACCE was 23.63％.A percentage of 72.09 of the MACCEs had occurred in the first 2 years after the PCI.According to the multivariate-adjusted Cox regression analysis,diameter of left main stent (HR =0.37,95％ CI0.17-0.82,P =0.014),bifurcation lesion (HR =1.92,95％ CI1.O1-3.62,P =0.045),smoking index ＞ 50pack / year (HR =3.78;95％ CI1.29-11.05,P =0.015) were the independent risk factors of MACCE.EuroSCORE Ⅱ ≥2％ (HR =3.96,95％ CI1.15-13.61,P =0.029) was the independent risk factor of all-cause death.Conclusion The prognosis of PCI-treated ULMCA disease is generally favorable.Most MACCEs occurred in the first 2 years after the PCI.Small left main stents diameter,bifurcation lesions,smoking index ＞ 50 pack/year and EuroSCORE Ⅱ ≥2％ were the risk factors for poor prognosis in patients with ULMCA disease.