The effects of PCI complete or incomplete revascularization in coronary heart disease patients:long-term prognosis and prognosis factors analysis

doi:10.3969/.issn.1674-3245.2018.02.002

Abstract：Objective The differences in clinical features and long-term major adverse cardiac events(major adverse cardiac events,MACE)were analyzed and compared between the complete revascularization(CR)and incomplete revascularization(IR)groups, in PCI-treated patients. Methods This study was a retrospective case analysis of a total of 250 patients from the intervention center of the cardiology department in the PLA General Hospital who had undergone successful PCI treatment from Jun 2004 to Mar 2006 and were followed-up successfully from Oct 2009 to Mar 2010 by telephone,outpatient visit or re-hospitalization. Patients were divided into 2 groups according to PCI-CR or IR,CR:(n=114 patients),IR:(n=136 patients). The baseline data,coronary artery lesion types and parameters related PCI operation were recorded and compared between groups. The long-term survival was analyzed by Kaplan-Meier table estimates and log-rank tests. Binary logistic regression eliminated the confounding factors of MACE. Results The average follow-up time was 5 years. No baseline data showed significant differences(P > 0.05)except for the family history of cardiovascular disease, which was lower in CR than in IR(P < 0.05). The complex lesion(B2+C)type distribution,the mean SYNTAX scores/implantation stent diameter and length were lower in CR than in IR(P<0.05).The endpoints:Total MACE and re-MI were significantly lower in CR than in IR(P<0.05);TVR/TLR and all-cause death showed the same results as the former but had no significant difference(P>0.05).The secondary point re-angina events in CR were significantly lower than those of IR(P<0.05). Kaplan-Meier survival analysis showed that the mean survival time and median-survival time were longer in CR and that the cumulative risk function of the IR curve was the upper limit of CR(P<0.05).Binary logistic regression analysis indicated that day-cigarette numbers(P < 0.05)and left ventricular systolic diameter(LVSD)(P < 0.05)were primary risk factors of MACE incidence after adjusting for possible confounding factors. Conclusion The CR strategy significantly improved survival quality as is as the rate of the cohorts with PCI-treatment during long-term follow-up. It will be more rational to prefer the CR strategy in practice where possible. A reduction in day-cigarette numbers and paying attention to LVSD change will have a positive impact on the prognosis of PCI patients.