Short - Term Effect Of Interventional Therapy For Coronary Artery Bypass Grafting In Elderly Patients With Coronary Heart Disease

Objectives: To analyse the recent changes of hemodynamics and neuroendocrine in elderly patients who were given different treatment modalities(optimal medical therapy, optimal medical therap and interventional therapy) for recurrent angina after Coronary Artery Bypass Graft. To analyse the correlation between cardiac hemodynamics and neuroendocrine To evaluate the recent effect of In situ blood vessels or bridge vascular interventional treatment for recurrent angina after artery bypass surgery.Methods: Admission clinical baseline data of patients with recurrent angina were collected.these patients had been undergoing coronary artery bypass grafting in our hospital in January 2007 and December 2012. The patients were divided by undergoing interventional surgery into two groups. The PCI group was treated with in situ or endovascular grafts(PCI Percutaneous Coronary Intervention) and optimized drug treatment. The ODT group received optimal medical(ODT Optimize Drugs Treat) treatment. Three months later, cardiac hemodynamics and neuroendocrine levels,cardiac function, major adverse cardiovascular events(MACE) and prognosis were followed-up.Results: Before undergoing PCI surgery, No statistical differences(p>0.05)were found between the two groups on baseline factors: age、gender、coronary artery bypass bridge age,、history of hypertension,、diabetes、Blood renin activity、angiotensin、norepinephrine, epiphrine, hemoglobin content of urea, creatinine, B-type brain natriuretic peptide、left ventricular diastolic diameterne, left ventricular ejection fraction, and recurrent angina time. After undergoing PCI surgery, the difference of related auxiliary examination results in the two groups showed statistically significant in Blood renin activity、angiotensin、norepinephrine, epiphrine, hemoglobin content of urea, creatinine, B-type brain natriuretic peptide、left ventricular diastolic diameterne and left ventricular ejection fraction(P<0.05), PCI group reduced neuroendocrine and improve cardiac hemodynamic better than ODT group. The rates of recent death and chest pain symptoms with relief were not statistically significant,the rates of increasing chest pain symptoms 、chest pain symptoms with no relief 、disappearing Chest pain and the total efficiency were statistically significant in two groups(P <0.05). Using multiariable Logistic regression analysis: levels of Hb(g / L) related factors of chest pain symptoms.(B-3.991,S.E 1.940,Wals 4.231,P 0.04,OR 0.018,95% CI 0.000-0.828).Using Pearson correlation analysis to understand that Cardiac hemodynamics and neuroendocrine levels showed a negative correlation, Cardiac hemodynamics and neuroendocrine levels showed a negative correlation,there were statistically significant(P <0.05).Conclusion: PCI group significantly lowered levels of associated cardiac adverse factors than the ODT group;PCI group was more efficient than ODT group;Levels of Hb(g/L)were associated with clinical symptoms of chest pain;Cardiac hemodynamics and neuroendocrine levels showed a negative correlation.