Prospective analysis of the effect of direct complete revascularization on the prognosis of elderly patients with acute ST-segment elevation myocardial infarction complicated with multivessel disease
Nie Maoxiao
Chen Qing
Zhao Quanming
Abstract：Objective This study was designed to compare the effects of different strategies of revascularization on the prognosis of elderly patients with acute ST-segment elevation myocardial infarction complicated with multivessel disease. Methods A total of 281 elder patients (age≥60 years) which combined multi-vessel disease (pathological vessels ≥ 2) and underwent emergency percutaneous coronary intervention (PCI) in the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, from September 2012 to August 2015 were enrolled. Patients were divided into direct complete revascularization group (77 cases) and divided revascularization group (204 cases) according to coronary revascularization. Results There were no significant differences in sex ratio, hypertension, diabetes mellitus and coronary artery lesions between the two groups. The incidence of acute thrombosis in the direct complete revascularization group was significantly higher than that in the divided revascularization group (6.5% vs. 1.5%, P=0.032), but the incidence of heart failure in the two groups during hospitalization (1.0% vs. 1.3%, P=0.329), cardiac tamponade (0 vs. 0, P=1.000), hemorrhagic complications (2.5% vs. 2.6%, P=0.840), incidence of peripheral vascular thrombosis events (1.0% vs. 1.3%, P=0.329) had no significant difference. The mean follow-up was 24.9±5.8 months, and The incidence of cardiac death between the two groups was 1.8% vs. 2.0%, P=0.811). The incidence of re-infarction (5.4% vs. 5.2%, P=0.442), stroke (4.4% vs. 3.9%, P=0.643), revascularization (7.8% vs. 6.5%, P=0.589) and re-hospitalization (48.0% vs. 50.6%, P=0.529) had no significant difference. Conclusion Compared with the divided revascularization group, direct total revascularization strategy did not significantly improve the prognosis of elderly patients with acute ST-segment elevation myocardial infarction complicated with multi-vessel lesions, and increased the risk of acute thromboembolic events after surgery.
Keywords：Elderly patientsST-segment elevation myocardial infarctionPercutaneous coronary intervention
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 530-533 )