Effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI / 中华老年心脑血管病杂志

ABSTRACT

Objective To assess the effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI.Methods 1055 CHD patients with DM undergoing PCI were divided into complete revascularization (CR) group (n=261),non-CR group 1 (n=385) and non-CR group 2 (n=409).The patients were followed up for 2 years during which the cardiovascular events were recorded.The SYNTAX revascularization index (SRI) was calculated according to the ROC curve and the best prognostic accuracy of revascularization was assayed.Results A significant difference was found in the incidence of MACE,angina pectoris,motality,cardiogenic death,myocardial infarction,unplanned revascularization during the 2-year follow-up period (P＜ 0.05,P＜0.01).Logistic regression analysis showed that SRI was a protective factor for MACE,reduced 64％ of MACE,and thus played a great role in predicting the incidence of MACE in elderly CHD patients with DM after 2 years of PCI (P=0.010).The area under the ROC curve showed the best prognostic accuracy of revascularization was 65％.Conclusion The incidence of cardiovascular events is low in elderly CHD patients with DM after 2 years of CR.The revascularization rate should be higher than 65％ for those who cannot undergo CR in order to reduce their mortality during the long-term follow-up period.