The Analysis Of The Factors Affecting The Formation Of Collateral Circulation And Short-term Effect Of Percutanous Coronary Intervention In Elderly Patients With Coronary Heart Disease

ObjectiveThis research is to discuss the related factor of the formation of collateral circulation in elderly patients and the short-term effect of PCI under the condition of collateral circulation.Materials and Methods1. Objective of the researchIn this research we selected171cases from Jan2012to Sep2012that meeting the following standards-elderly patients with coronary heart disease after percutaneous coronary intervention in Zhujiang Hospital. The patients were aged61-89years including male110cases, female81cases, whose mean age is71.61±6.43.Selection criteria:patients who is older than60years, had complete clinical data and coronary angiography results, and patients confirmed by coronary angiography and at least one branch of coronary artery stenosis overpass75%.Exclusion criteria:(1) patients who once had coronary revascularization, such as coronary artery bypass surgery, percutaneous coronary intervention, coronary angioplasty.(2) patients who underwent bone marrow or transplant;(3) patients with valvular heart disease, cardiomyopathy, pulmonary heart disease, congenital heart disease;(4) patients with malignant tumor;(5) patients complicated with multiple organ failure, uremia.2. Research methods and date collectionThe patients were divided into2groups:collateral circulation group and without collateral circulation based on the results of coronary arteriography. Collateral circulation group was defined from1to3while without collateral circulation group was defined0.We collected the date that may be influenced the establishment of collateral circulation:basic information, including patient’s blood biochemical examination results, laboratory test results, the results of coronary angiography and PCI postoperative hospitalization time, major adverse cardiovascular events and complications.3. Data processingData were processed by SPSS19statistical software package. The measurement data are defined as X±SD while the differences between groups using Two independent samples t-test. whereas discrete variables are expressed as percentages, compared by means of the chi-square test. P<0.05was defined to be statistically differences.Results1There were no statistically difference in the two group(P>0.05) in age, gender, smoking rate, TG, TC, HDL-C, LDL-C,blood sugar and pathological changes of vessel.2The hypertension rate of the two group is30.2%to43.5%while the occurrence of ventricular aneurysm is5.8%to10.6%, with no statistical differences.3In this research, we found that there had a statistically significant difference in the rate of diabetes, preinfarction angina, hospitalization duration, coronary artery stenosis (P<0.01), The proportions of right coronary artery disease, and major adverse cardiovascular events and complications (52.9%VS19.4%, P<0.01)ConclusionFor the elderly patients with coronary artery disease treated by PCI:1The parameters including age, gender, smoking, hypertension, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein, the number of diseased vessels had no significant effect to the formation of collateral circulation.2Dabetes have an adverse effect on the formation of coronary collateral circulation. The patients with angina are more likely to have collateral circulation than those without angina.3The degree of coronary artery stenosis is the main factors inducing the formation of coronary collateral circulation.4、occluded RCA is easier to have benign collateral circulation than the occluded LAD and LCX.5coronary collateral circulation can protect cardiac function, reduce major adverse cardiac events and complications and improve the effect fo PCI treatment.