| BackgroundPercutaneous coronary intervention (PCI) is the main method for the treatment of coronary heart disease (CHD), antiplatelet therapy is highly recommended after PCI. However, the effect and safety of dual antiplatelet therapy with aspirin and clopidogrel in elderly patients, especially in over75years old patients, needs more research to make more benefit for them.ObjectivesThis study is aimed to:Evaluate and compare the incidence of major adverse cardiac events (MACE) with dual antiplatelet therapy in different groups. Evaluate and compare the incidence of bleeding complications with dual antiplatelet therapy in different groups. Try to investigate the relationship between the MACE and bleeding complications and the age of the patients.MethodsClinical data is collected from the patients who underwent PCI and take dual antiplatelet therapy with aspirin and clopidogrel in the Second Affiliated Hospital of Zhejiang University. Based on the inclusion and exclusion criteria, we collected a total of120patients with coronary heart disease who were older than75years old, named the elderly group. While selected120patients whose age were under75years old appropriately as the control group, named the younger group, the collection method is to select the younger patients within the week before and after the date when elderly patients undergoing PCI treatment. The younger group patients whose sex, risk factors for coronary heart disease, type and numbers of stents were most similar with the elderly group. We totally collected240cases of patients.Based on the patients’age,240patients were divided into group A (age<75years, n=120), group B (age≥75years, n=120), evaluate and compare the clinical data (including age, gender, smoking history, BMI, hypertension, diabetes, hyperlipidemia, drugs, the type and numbers of stents), MACE (including stroke, myocardial infarction, revascularization, death) and bleeding complications (including serious complications such as gastrointestinal bleeding, cerebral hemorrhage and minor bleeding complications such as skin and mucosal ecchymosis, melena).Results1. About MACE,the incidence of myocardial infarction in group A is less than group B (1.7%vs6.7%, P=0.053); the incidence of stroke and revascularization, group A is less than group B, above all, the difference was not statistically significant (P>0.05). But with the overall incidence of MACE, group A and group B groups are respectively5.8%,14.2%, P=0.031. The difference was statistically significant.2. About bleeding complications in both groups, the overall incidence of bleeding complications in group A and group B are3.3%vs7.5%, P=0.154, indicate that elderly patients(age≥75years old) have slightly higher probability of minor bleeding complications than young patients (age<75years), but the difference was not statistically significant.Conclusions1. Patients who are undergoing PCI treatment and postoperative long-term use of dual antiplatelet therapy with aspirin and clopidogrel, the probability of the overall incidence of major adverse cardiovascular events (MACE) increases with the increase of age.2. Patients who are undergoing PCI treatment and postoperative long-term use of dual antiplatelet therapy with aspirin and clopidogrel, bleeding complications caused by antiplatelet drugs did not significantly increase with the increase of age. |
