| Objective:Through the study of coronary heart disease of unprotected left main coronary artery disease(ULMCA)in patients with percutaneous coronary intervention(PCI)for the treatment of the effect of gender difference,we can provides the basis of different gender patients with ULMCA PCI and short-and long-term curative effect.Methods:We analysed 173 patients who were diagnosed with coronary heart disease of unprotected left main coronary artery disease and get treated with PCI in Cangzhou Center Hospital during 2010.1-2014.12,and did the Retrospective analysis.There are 52 females and 121 males,and the average age of them were 61.02±7.95 years old.The standard of the patients:1.The left coronary artery,coronary angiography(CAG)examination showed the left main parts exist narrow parts,and there is no patency of grafts or from right to left collateral circulation blood supply.2.PCI treatment.The exclude standard of the patients: The intolerant of anti-platelet therapy for patients,or patients who were allergy to aspirin and clopidogrel;the serious liver and kidney dysfunction,or allergy to contrast agent;the hemorrhagic disease.We divided them into two groups according to the different sex.We call them “male group” and “female group”.We compared the clinical baseline data,CAG results and PCI treatment in different gender groups,and compared the results of two groups of patients during the period of hospitalization and postoperative follow-up(1 to 3 years).The main feedback of this clinic experiment were adverse cardiovascular and cerebral blood vascular events,including cardiac death,non cardiac death,acute myocardial infarction(AMI)and target lesion blood transport reconstruction.Statistical analysis : Using SPSS17.0 statistical software for statistical processing and analysis of clinical data.The measurement data are expressed as mean plus or minus standard deviation,and the count data are expressed as frequency or rate.Measurement data was used for t test,count data was used for chi square test.We will observe the meaningful results if P<0.05.Results: Baseline characteristics: male group in weight(76.17± 9.43 kg vs.67.84±11.18 kg,P<0.01)and height(170.53±5.49 cm vs.158.82±7.12 cm,P<0.01)are obviously higher than those of female group,and the proportion of smokers also significantly higher than female group(49.6% vs.15.4%,P<0.01).In terms of age,body mass index,hypertension,diabetes,family history of CHD,PCI,CABG history and other clinical baseline data,there was no significant difference between the two groups(P>0.05).The female group was higher than the male group in the aspects of hyperlipidemia(7.7% vs.4.1%)and AMI(11.5% vs.5.8%),but the difference was not statistically significant(P>0.05).The male group was higher than the female group in the history of CABG(3.3% vs.0),but the difference was not statistically significant(P>0.05).There was no significant difference between the two groups(P>0.05)in the examination of cardiac troponin I(c Tn I)and left ventricular ejection fraction(LVEF).The treatment between CAG and PCI: At the puncture site selection,the female group was higher than the male group(36.5% vs.21.5%,P<0.05)via the femoral artery approach(vs.,TRA),while the male group was higher than the female group(78.5% vs.63.5%,P<0.05),the radial artery approach(vs.,TFA).In the target vessel lesion(lesion size,lesion length,degree of stenosis),target target lesion types(ostial lesion,the body of the lesion,the end of the bifurcation lesions),left main with the number of diseased vessels(Dan disease,with single branch lesion,with double vessel disease,with three vessel disease),bifurcation stent(cross-over perfectly support technologies,V stent technology,crush stent technology,Culottes stent technology and final balloon for kissing),stent types(bare metal stents,drug eluting stents,stent size(the diameter of the stent,stent length,support a number of female group and male group difference was not statistically significant(P>0.05).There was no significant difference between the female group and the male group(P>0.05)in the aspects of complications such as blood transfusion,stent restenosis,subacute thrombosis,infection of the puncture site(P>0.05).And the female group in the false aneurysm(3.8% vs.0.8%),puncture site hematoma(3.8% vs.0)were higher than the male group,but the difference was not statistically significant(P>0.05).Follow-up results after hospitalization and PCI : During hospitalization,patients in the two groups didn’t have inadvertently reconstruction and death which was caused by the relation of heart disease that may lead patient who was probably vulnerable to a dangerous situation,and target lesion blood;The group of women in non cardiogenic death(1.9% vs.0),PCI of AMI(3.8% vs.0.8%)and MACCE(5.8% vs.0.8%)were higher than those in male group,but the difference was not statistically significant(P>0.05).After discharge of all patients were followed up for 1~3 years,the patients in the two groups are nothing but psychogenic death and AMI cases;female group in psychogenic death(1.9% 0),target lesion blood transport reconstruction(5.8% vs.2.5%)and MACCE(7.7% vs.2.5%)were higher than those in male group,but the difference was not statistically significant(P>0.05).Conclusion: In the present study,men were significantly higher in body weight and height than women.In the interventional treatment of ULMCA,females choose TFA but men choose tra;But in target lesion type and extent,left main with the number of diseased vessels,bifurcation stents,stent choice,surgical complications such as men and women found no difference.Follow up in the hospital and PCI after 1 to 3 years,MACCE has not found the women also found no differences.Therefore,gender has no effect on interventional treatment of ULMCA overall,male and female treatment has a good therapeutic effect in ULMCA,but it should be noted that the selection of approach on the difference between men and women. |
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