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目的:分析预测冠心病患者冠状动脉介入治疗术(PCI)后长期临床效果的预测因素。方法:收集592例冠心病患者PCI后的临床资料并进行随访,随访主要不良心血管事件(MACE)发生情况并经多元logistic回归的方法分析这些事件的相关因素。结果:平均随访时间18.96(3～57)个月。MACE的发生率为7.6%,全因性死亡率为2.4%,非致死性心肌梗死发生率为1.5%。MACE发生的预测因素有PCI方式、近段病变、参考血管的直径及氯吡格雷的应用时间,年龄、有心肌梗死史及氯吡格雷应用时间可预测全因性死亡,术后未戒烟及完全停止抗血小板治疗增加非致死性心肌梗死的危险。结论:高龄、单纯经皮冠状动脉球囊成形术或置入金属裸支架、小血管病变、近段病变和对抗血小板治疗及戒烟的依从性差是预测PCI后不良预后的因素。
OBJECTIVE: To analyze the predictors of long-term clinical outcome after coronary intervention (PCI) in patients with coronary heart disease. Methods: The clinical data of 592 CHD patients after PCI were collected and followed up. The incidence of major adverse cardiovascular events (MACE) were followed up and multivariate logistic regression analysis was used to analyze the related factors of these events. Results: The average follow-up time was 18.96 (3-57) months. The incidence of MACE was 7.6%, all-cause mortality was 2.4% and non-fatal MI was 1.5%. Predictors of MACE include PCI, proximal lesions, diameter of reference vessels, and duration of use of clopidogrel, age, history of myocardial infarction, and duration of clopidogrel prediction of all-cause mortality, postpartum smoking cessation, and complete Stop antiplatelet therapy increases the risk of non-fatal myocardial infarction. Conclusions: Elderly, simple percutaneous transluminal coronary angioplasty or bare metal stent implantation, small vessel disease, proximal lesions and poor compliance with antiplatelet therapy and smoking cessation are the factors that predict the adverse prognosis after PCI.