The factors to influence the prognosis of patients with coronary artery disease undergoing percutaneous coronary intervention

Objective To evaluate the clinical characteristics and outcomes of elder patients undergoing percutaneous coronary intervention (PCI).Methods One hundred and seventy-nine consecutive patients with coronary artery disease(CAD) were divided into group A (≥70 years old,n=93) and group B ( 70 years old,n=86). Serum creatine phosphokinase isoenzyme (CK-MB) and creatinine(SCr) levels were measured before and after PCI.Left ventricular end-diastolic diameter (LVDD) and left ventricular ejection function (LVEF) were assessed before PCI. The characteristics of coronary artery and major adverse cardiovascular events (MACEs) occurred in hospital and 5-23 months after discharge were registered. Results Compared with group B,the patients in group A significantly had more accompanied events such as hypertension,type 2 diabetes,cerebral arterial thrombosis,chronic obstructive pulmonary disease,higher LVDD and lower LVEF,higher level of CK-MB 24 h after PCI,and higher level of SCr before PCI and on the 3rd day after PCI.The numbers of the diseased vessels and stents,the hospitalization time and the incidence of complex lesions,bifurcate lesions,calcification lesions,chronic total occlusion lesions and complications during PCI were significantly higher in group A than those in group B.MACEs during hospitalization and 5-23 months follow-up were more in group A than those in group B.Multivariate COX regression analysis revealed that the MACE increaseed 199.4% in diabetics compared with non-diabetics(P0.01),and increased 118.8%(P0.01) when age went one class up(25 percent),but decreased 46.2%(P0.01) when LVEF went one class up(25 percent).Conclution PCI in aged patients with CAD has more complications,complex coronary artery lesions and lower LVEF and poorer prognosis.Type 2 diabetes,age and LVEF are the independent predictors for MACE in CAD patients after PCI.