他汀药物预治疗对高龄冠心病患者支架术预后的影响

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1、医学杂志2010年8月24日第90卷第32期NatlMed』些：垒丝!：!：：·2255．临床研究．他汀药物预治疗对高龄冠心病患者支架术预后的影响马涵英赵铁夫张银凤史宏志韩红亚周玉杰RonaldJDick【摘要】目的探讨术前他汀类药物治疗对高龄冠心病患者经皮冠状动脉支架治疗近期和远期预后的影响。方法回顾性分析90例85岁以上冠心病患者术前他汀应用情况，观察其对预后的影响。结果90例患者中，33例经皮冠状动脉介入(PCI)术前接受他汀治疗，57例PCI术前未接受他汀治疗。80例(88．9％)为急性冠状动

2、脉综合征。术前接受他汀治疗组血脂异常、既往心肌梗死病史、既往PCI、开口病变、药物涂层支架(DES)植入比例比例略高。住院期间主要心血管不良事件(MACE)发生率要低于术前未接受他汀治疗组(3．0％比10．5％，P=0．05)。随访1年时MACE发生率两组相似(6．1％与3．8％，P=0．07)。整个研究人群1年生存率较高。结论他汀预治疗对高龄冠心病支架术后可能降低住院期间MACE，而不一定能改善1年预后。【关键词】血管成形术，经腔，经皮冠状动脉；预后；他汀Effectofpreviousstatin

3、sonprognosisofoctogenarianpatients’’，ithcoronaryheartdisease、vithpercutaneouscoronarystentingMAHan—ying，ZHAO死e，ZHANGYin-feng，Sillr0一zhi，HAN舶一ya，ZHOUYu-fie，RonaldJDick．12thDepartmentofCardiology，BeijingAnzhenHospital，CapitalMedicalUniversity，Beijing10002

4、9，ChinaCorrespondingauthor：ZHOUYu-fie，12thDepartmentofCardiology，BeijingAnzhenHospital，CapitalMedicalUniversity，Beijing100029，China，Email：mahanying@126．COin【Abstract]0bjecfiveToevaluatetheefectofstatinpretreatmentonprognosisofoctogenarianpatientswithcor

5、onaryheartdiseasewithpercutaneouscoronaryintervention(PCI)．MethodsAtotalof90patientsagedat85yearsoldandoverwithcoronaryheartdisease(CAD)undergoingstentingwereenrolled．Thedurationofstatin，hospitalizationandone—yearclinicalfollow—upoutcomeincludingall—cau

6、semortality，majoradversecardiacevent(MACE)，strokeandothermajorhemorrhageswerecollectedandanalyzed．ResultsAmongthesepatients，33(36．7％)receivedastatinpre—treatmentforatleast2daysand57(63．3％)didnot．Patientsonastatinpre—treatmentweremorelikelytohavehyperten

7、sion，hyperlipdemiaandahistoryofmyocardialinfractionandPCI．Theprocedurecharacteristicsweresimilarbetweentwogroups．Despitethehigherriskprofile，thepatientsonastatinpre—treatmenthadalowerhospitalizationMACErate(3．0％VS10．5％，P=0．05)．However，atoneyear，thepatie

8、ntsonastatinpre—treatmenthadasimilarMACErate(6．1％VS3．8％，P=0．07)astheothergroup．ConclusionThestatinpretreatmentinoctogenarianCADpatientswithPCImaybeassociatedwithareducedhospitalizationMACErate．【Keywords】Angioplasty，transluminal，p