多因素冠状动脉疾病患者经皮血管重建术老年综合征的预后影响

Rocío de Lemos-Albaladejo, Miguel Jerez-Valero, Luis M. Perez-Belmonte, Antonio J. Muñoz-García, Antonio Dominguez-Franco, Fernando Carrasco-Chinchilla, Eva Chueca-Gonzalez, Jose M. Hernández-García, Eduardo de Teresa Galván, Manuel Jimenez-Navarro
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引用次数: 0

摘要

背景与目的缺血性心脏病是老年人死亡的第一大原因。老年综合征与这一年龄段发病率和死亡率的增加有关。本研究的目的是评估经皮冠状动脉血管重建术对老年患者老年综合征的影响。方法前瞻性纳入220例多支冠状动脉病变患者。采用Fried问卷对老年综合征进行评价,采用Charlson指数对合并症进行评价,采用Barthel指数对躯体残疾进行评价。结果42.1%的患者存在一定程度的虚弱(Fried≥1),存在一定程度的身体残疾(Barthel <100),占21.8%,Charlson指数平均值为4(3-6)。发生一些主要心血管事件(MACE, 12.7%)的患者有更多的虚弱(75比11%,P = .002)、身体残疾(45.8比17.2%,P = .002)和合并症(Charlson指数6[4-7]比4 [3-6],P = .004)。在随访中,我们发现完成血运重建术后MACE有降低的趋势(OR 0.48, 95% CI 0.2-1.15, P≤0.099)。结论在我们的人群中,老年综合征在MACE患者中更为常见。我们观察到当冠状动脉经皮血运重建术完成后,主要心血管事件有减少的趋势。
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Impacto pronóstico de los síndromes geriátricos en pacientes con enfermedad coronaria multivaso que reciben revascularización percutánea

Background and objectives

The ischemic cardiopathy is the first cause of death in elderly. The geriatrics syndromes are related with an increase of morbidity and mortality in this age margin. The aim of the study was the influence evaluation of the geriatric syndromes in elderly patients undergoing percutaneous coronary revascularization.

Methods

We have included 220 patients prospectively with multivessel coronary disease. The geriatric syndromes evaluated were: frailty by Fried questionnaire, comorbidity by Charlson index and physical disability by Barthel index.

Results

The 42.1% of the patients had some level of frailty (Fried  1), it was observed some level of physical disability (Barthel < 100) in 21.8% and the mean of the Charlson index was 4 (3-6). The patients that suffered some major cardiovascular event (MACE, 12.7%) had more frailty (75 vs. 11%, P = .002), physical disability (45.8 vs. 17.2%, P = .002) and comorbidity (Charlson index 6 [4-7] vs. 4 [3-6], P = .004]. In the follow up we found a tendency of MACE decrease when a completed revascularization was done (OR 0.48, 95% CI 0.2-1.15, P  .099).

Conclusions

In our population the geriatric syndromes studied are more frequent in patients that suffer MACE. We observe a tendency of decreasing mayor cardiovascular events when the coronary percutaneous revascularization is completed.

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