Correlative Study Of Coronary Heart Disease With Special Clinical

Objective To analyze the clinical parameters and long-term follow-up of patients with acute myocardial infarction complicated with acute pulmonary embolism,in order to explore the risk factors of the disease、estimate the outcomes of different antithrombotic drugs and evaluate the prognosis of patients. Methods A total of 34 patients with acute myocardial infarction complicated with acute pulmonary embolism were enrolled from March 2004 to May 2014 in Fuwai Hospital. Their clinical parameters were analyzed and they were followed up by telephone. Survivals were analyzed by Kaplan-Meier method. Results the rate of older than 60 years old、 hypertension、diabetes mellitus、hyperlipidemia、oronary heart disease、being bedridden is relatively higher among these patients. The clinical symptoms of them mainly included chest distress、dyspnea、chest pain and diaphoresis. The clinical signs mainly included pulmonary rales. They were mainly diagnosed by spiral computed tomography. The bleeding risk of Triple antithrombotic therapy(aspirin, clopidogrel and warfarin) is higher, but all the bleeding events belonged to nonfatal bleeding, and none of thromboembolic events occurred in this group. So the triple antithrombotic therapy is relatively safe and effective compared with other therapies. Overall mortality of these people is 20.6%, higher than acute myocardial infarction or acute pulmonary embolism. Conclusion patients with acute myocardial infarction complicated with acute pulmonary embolism often had complex clinical situation and a poor prognosis, whose symptoms of chest distress、dyspnea、chest pain and diaphoresis were obvious, mainly diagnosed by spiral computed tomography. Triple antithrombotic therapy was safe and effective.Objective To explore the gender difference of long-term outcomes in patients at 75 years or elder after percutaneous coronary intervention (PCI) treatment. Methods A total of 29211 consecutive patients who received PCI in our hospital from 2004-04 to 2010-11 were retrospectively studied. The patients were divided into 4 group: Group① Female≥75 years of age, N=521, Group② Female<75 years, N=5666 and Group③ Male≥75 years, n=1098, Group④ Male< 75 years group, n= 21926. The in-hospital and mid-term clinical outcome after PCI treatment were compared among different groups. Results The in-hospital cardiac death in Group① was higher than the other 3 groups, P<0.05. Kaplan-Meier estimated 3-year rate of cardiac death was significantly higher in elderly females (≥75 years old) in comparison with all other groups (P<0.05).Cox proportional hazard model analysis indicated that compared with Group② and Group④, the female≥ 75 years was the independent risk factor for cardiac death (HR=2.53,95% CI 1.15-5.59; HR=2.22,95% CI 1.26-3.91) and cardiac death/MI (HR=2.26,95% CI 1.27-4.03; HR=2.25,95% CI 1.44-3.51). While compared with the male≥75 years, the female≥75 years was not an independent risk factor for cardiac death (HR= 1.30,95%CI:0.97-1.71) and cardiac death/MI (HR= 1.21,95%CI:0.94-1.55). Conclusion Compared with other age groups, female patients at the age≥ 75 years could have worse in-hospital and long-term outcomes after PCI, while it was not the independent risk factor for cardiac death and cardiac death/MI in patients after PCI treatment.