{"title":"高龄患者的冠状动脉旁路移植术。","authors":"Roxana Sadeghi","doi":"10.48305/arya.2023.41535.2884","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients.</p><p><strong>Method: </strong>An observational case-control study was conducted involving 535 patients, divided into two groups: older adults (≥75 years) and younger adults (<75 years). All patients underwent CABG following a similar protocol. The primary endpoints focused on early post-procedure outcomes, including in-hospital mortality and the duration of ICU or hospital stay. Patients were followed up for six months, and secondary study endpoints included long-term mortality, left ventricular ejection fraction, re-hospitalization rates, and repeated revascularization.</p><p><strong>Results: </strong>535 patients who underwent CABG were enrolled in this study. The smoking habit was significantly higher among younger adults (38.2% vs. 12.5%, P=0.001). Hypertension was more prevalent among older adults than younger adults (75% vs. 60%, P=0.044). LDL cholesterol serum levels were higher among younger adult patients (94.9±32.5 vs. 80.9±32.9, P=0.028). In-hospital death was not significantly different between younger and older adults (2.8% vs. 5.0%, P=0.34). Mortality in the six-month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06).A significant proportion of patients in both groups (46.9% in younger patients vs. 40% in older ones, P=0.40) received dual antiplatelet therapy (DAPT) prior to CABG due to a recent myocardial infarction and receipt of a new stent, but without increased major bleeding in both groups.</p><p><strong>Conclusion: </strong>CABG should be considered a viable treatment option for elderly patients with acceptable operative risk in current clinical practice.</p>","PeriodicalId":46477,"journal":{"name":"ARYA Atherosclerosis","volume":"19 4","pages":"37-45"},"PeriodicalIF":0.5000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179009/pdf/","citationCount":"0","resultStr":"{\"title\":\"Coronary Artery Bypass Grafting in advance aged patients.\",\"authors\":\"Roxana Sadeghi\",\"doi\":\"10.48305/arya.2023.41535.2884\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients.</p><p><strong>Method: </strong>An observational case-control study was conducted involving 535 patients, divided into two groups: older adults (≥75 years) and younger adults (<75 years). All patients underwent CABG following a similar protocol. The primary endpoints focused on early post-procedure outcomes, including in-hospital mortality and the duration of ICU or hospital stay. Patients were followed up for six months, and secondary study endpoints included long-term mortality, left ventricular ejection fraction, re-hospitalization rates, and repeated revascularization.</p><p><strong>Results: </strong>535 patients who underwent CABG were enrolled in this study. The smoking habit was significantly higher among younger adults (38.2% vs. 12.5%, P=0.001). Hypertension was more prevalent among older adults than younger adults (75% vs. 60%, P=0.044). LDL cholesterol serum levels were higher among younger adult patients (94.9±32.5 vs. 80.9±32.9, P=0.028). In-hospital death was not significantly different between younger and older adults (2.8% vs. 5.0%, P=0.34). Mortality in the six-month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06).A significant proportion of patients in both groups (46.9% in younger patients vs. 40% in older ones, P=0.40) received dual antiplatelet therapy (DAPT) prior to CABG due to a recent myocardial infarction and receipt of a new stent, but without increased major bleeding in both groups.</p><p><strong>Conclusion: </strong>CABG should be considered a viable treatment option for elderly patients with acceptable operative risk in current clinical practice.</p>\",\"PeriodicalId\":46477,\"journal\":{\"name\":\"ARYA Atherosclerosis\",\"volume\":\"19 4\",\"pages\":\"37-45\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179009/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ARYA Atherosclerosis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.48305/arya.2023.41535.2884\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ARYA Atherosclerosis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.48305/arya.2023.41535.2884","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
简介:本研究旨在评估与年轻患者相比,冠状动脉搭桥术(CABG)对老年患者预后的影响:本研究旨在评估与年轻患者相比,冠状动脉旁路移植术(CABG)对老年患者预后的影响:方法:进行一项观察性病例对照研究,将 535 名患者分为两组:老年人(≥75 岁)和年轻人:本研究共纳入了 535 名接受心血管造影术的患者。年轻人的吸烟率明显更高(38.2% 对 12.5%,P=0.001)。高血压在老年人中的发病率高于年轻人(75% 对 60%,P=0.044)。年轻成人患者的低密度脂蛋白胆固醇血清水平更高(94.9±32.5 vs. 80.9±32.9,P=0.028)。年轻人和老年人的院内死亡率无明显差异(2.8% vs. 5.0%,P=0.34)。两组患者中都有相当比例的患者(年轻患者为46.9%,老年患者为40%,P=0.40)在接受CABG手术前接受了双联抗血小板治疗(DAPT),原因是近期发生了心肌梗死和接受了新的支架,但两组患者的大出血都没有增加:结论:在目前的临床实践中,对于手术风险可接受的老年患者,CABG 应被视为一种可行的治疗方案。
Coronary Artery Bypass Grafting in advance aged patients.
Introduction: This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients.
Method: An observational case-control study was conducted involving 535 patients, divided into two groups: older adults (≥75 years) and younger adults (<75 years). All patients underwent CABG following a similar protocol. The primary endpoints focused on early post-procedure outcomes, including in-hospital mortality and the duration of ICU or hospital stay. Patients were followed up for six months, and secondary study endpoints included long-term mortality, left ventricular ejection fraction, re-hospitalization rates, and repeated revascularization.
Results: 535 patients who underwent CABG were enrolled in this study. The smoking habit was significantly higher among younger adults (38.2% vs. 12.5%, P=0.001). Hypertension was more prevalent among older adults than younger adults (75% vs. 60%, P=0.044). LDL cholesterol serum levels were higher among younger adult patients (94.9±32.5 vs. 80.9±32.9, P=0.028). In-hospital death was not significantly different between younger and older adults (2.8% vs. 5.0%, P=0.34). Mortality in the six-month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06).A significant proportion of patients in both groups (46.9% in younger patients vs. 40% in older ones, P=0.40) received dual antiplatelet therapy (DAPT) prior to CABG due to a recent myocardial infarction and receipt of a new stent, but without increased major bleeding in both groups.
Conclusion: CABG should be considered a viable treatment option for elderly patients with acceptable operative risk in current clinical practice.