Analysis Of Risk Factors For Complications After Percutaneous Coronary Intervention In Elderly Patients With Coronary Heart Disease

Objective:Aim to investigate baseline data,in-hospital condition,laboratory examinations,coronary lesions of coronary heart disease(CHD)patients ?75 who under percutaneous coronary intervention(PCI)and to analysis risk factors related to perioperative and short-term post-PCI complications.Methods:A retrospective study was conducted among total 1523 consecutive subjects who were hospitalized with CHD and underwent PCI in Chang-zheng Hospital from January 2011 to December 2014,there were 362 female and 1161 male subjects,average age was 64.85±10.94 years.All subjects were divided into two groups according to age: elderly group(age ? 75,n=337)and younger group(age < 75,n=1186).Clinical baseline data at admission(age,gender,weight,history of smoking,comorbidities,medical history,etc.),in-hospital laboratory examinations(routine blood test,coagulation function test,biochemical indicators,myocardial enzyme in serum,etc.),peri-procedural data(PCI approach,coronary lesions,implantation of stent,etc.),perioperative and short-term post-PCI complications(stent thrombosis,recurrent myocardial infraction,death,etc.)were collected,analyzed and compared between the two groups.All data were analyzed in software SPSS 19.0,qualitative data were presented as mean ± standard deviation and comparison of two group was formed by t test while binary data were presented by percentage and comparison of two group was formed by chi-square test or Fisher probabilities in 2×2 table data(when sample size is not enough).Univariable and multivariable logistic regression were used in analyzing risk factors related to outcomes of PCI in elderly group patients.The criterion for statistical significance was P<0.05.Results:1.Average age was 79.37±3.55 years in elderly group and 60.73±8.56 years in younger group,compared with younger group,the elderly group was more likely to be woman,less likely to be smoker and had a relative lower average weight.Hypertension,chronic kidney disease,chronic obstructive pulmonary disease,history of stroke,acute heart failure and severe arrhythmia at admission were more common to be seen in the elderly group.2.Compared with younger group,the elderly group had relative lower hemoglobin,blood platelet and albumin while creatinine,post-PCI creatinine,blood uric acid and blood urea nitrogen were higher.The elderly group also had relative lower triglyceride,cholesterol and higher high density lipoprotein,pro-BNP.Left anterior descending lesions,left circumflex lesions,left main lesions and triple-vessel lesions were more common to be seen in elderly group.Calcified lesions,chronic total occlusion were also more common to be seen in elderly group,the number of stent implantation showed no statistical difference between the two group.3.Compared with younger group,the elderly group had relative high in-hospital mortality,contrast-induced nephropathy and incidence of bleeding complication.At six months after PCI,the mortality and incidence of non-fatal myocardial infraction were also higher than the younger group.The incidence of MACEs and revascularization showed no statistical difference between two groups.4.Multivariate logistic regression showed that age ?85 years,emergency PCI,smoking,severe arrhythmia at admission,acute heart failure at admission,previous stroke were independent risk factors predicting six-month mortality in patients over 75 years who underwent PCI.Conclusions:Compared with younger group,hypertension,chronic kidney disease,chronic obstructive pulmonary disease,history of stroke was more common to be seen in the elderly group and the condition at admission was more severe.The elderly group had more complex coronary lesions including calcified and multi-vessel lesions,chronic total occlusion along with higher in-hospital and six-month mortality.Multivariate logistic regression showed that age ?85 years,emergency PCI,smoking,severe arrhythmia at admission,acute heart failure at admission,previous stroke were independent risk factors predicting six-month mortality in patients over 75 years who underwent PCI.