| Objective:At present,most of the guidelines have not given clear guidance on whether complete revascularization(CR)is needed or not due to the characteristics of acute coronary syndrome(ACS)combined with type 2 diabetes mellitus(T2DM)with multivessel disease(MVD),and it is still controversial at home and abroad.In this study,the clinical efficacy of different revascularization strategies and their influence on long-term prognosis were analyzed in patients with ACS complicated with T2DM undergoing percutaneous coronary intervention(PCI).MethodsThe clinical data of patients who underwent PCI in our hospital from August 2015 to August 2018 were reviewed.Patients with ACS complicated with T2DM who were diagnosed as MVD by coronary angiography(CAG)were included.According to the coronary revascularization method,they were divided into CR group(n<318)and incomplete revascularization(IR)group(n<3 06).Clinical baseline data,characteristics of coronary artery lesions,PCI and drug application,postoperative clinical effects and clinical events after 1 year of follow-up were collected for statistical analysis between the two groups,and the differences in prognosis of patients with different revascularization strategies were compared.Results:1.There were no statistical differences in age,gender,left ventricular ejection fraction and other baseline indicators between the two groups(P>0.05),but there were statistical differences in serum creatinine and serum uric acid(P=0.007,P=0.008).2.There was no statistical difference in the types of infarct related vessels between the two groups(P>0.05),the operative time and the number of stents implantation were statistically different(P=0.000,P=0.000).3.There was statistical difference in the long-term use of nitrate drugs between the two groups(P=0.014),and there was statistical difference in the left ventricular ejection fraction(P=0.007).4.There was no significant difference between the two groups in the primary end point of all-cause death cardiac death myocardial infarction events(P>0.05);There were statistically significant differences in major cardiovascular and cerebrovascular events(MACCE)and re-revascularization as secondary endpoints(P=0.006,P=0.000),and there were statistically significant differences in re-hospitalization for angina pectoris recurrence as other endpoints(P=0.000,P=0.026).There was no statistically significant difference in hospital cardiovascular events(P>0.05).Conclusion:1.In patients with ACS complicated with T2DM,there was no significant difference in all-cause mortality 1 year after CR versus IR,while the occurrence of MACCE was reduced.2.CR can reduce the number of re-revascularization and hospitalization of patients with angina pectoris recurrence and improve the quality of life of patients.3.On the basis of comprehensive consideration of the clinical characteristics of patients,patients with ACS complicated with T2DM received CR strategy,which did not increase the incidence of nosocomial cardiovascular events. |
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