Study on the influencing factors of adverse cardiovascular events in elderly patients with coronary heart disease after percutaneous coronary intervention
高龄冠心病患者行经皮冠状动脉介入治疗术后发生不良心血管事件的影响因素研究

摘要

目的 探讨高龄（≥75岁）冠心病患者行经皮冠状动脉介入治疗（PCI）术后发生不良心血管事件（MACE）的影响因素。方法 选取2023年1月—2025年1月我院接诊的100例高龄冠心病PCI术后患者为研究对象，根据术后6个月内是否发生MACE分为事件组（发生MACE，n=28）与非事件组（未发生MACE，n=72）。收集患者基线资料、手术相关指标、术后管理指标，采用单因素分析筛选差异变量，多因素Logistic回归分析确定MACE发生的独立影响因素。结果 单因素分析显示，事件组糖尿病史、多支血管病变、左心室射血分数（LVEF）<50%、术后抗血小板药物不依从、术后低密度脂蛋白胆固醇（LDL-C）≥1.8mmol/L比例高于非事件组（P<0.05）；多因素Logistic回归分析显示，糖尿病史、多支血管病变、LVEF<50%、术后抗血小板药物不依从、术后LDL-C≥1.8mmol/L是高龄冠心病患者PCI术后发生MACE的独立危险因素（P<0.05）。结论 高龄冠心病患者PCI术后MACE发生与糖尿病史、多支血管病变、心功能不全（LVEF<50%）、术后抗血小板不依从及血脂控制不佳密切相关，临床需针对这些危险因素制定个体化干预方案，以降低术后不良事件风险。

Abstract

Objective To explore the influencing factors of adverse cardiovascular events (MACE) in elderly (≥ 75 years old) patients with coronary heart disease after percutaneous coronary intervention (PCI).
Methods 100 elderly patients with coronary heart disease who underwent PCI in our hospital from January 2023 to January 2025 were selected as the study subjects. They were divided into an event group (with MACE occurrence, n=28) and a non event group (without MACE occurrence, n=72) based on whether MACE occurred within 6 months after surgery. Collect patient baseline data, surgical related indicators, and postoperative management indicators, use univariate analysis to screen for differential variables, and use multivariate logistic regression analysis to determine independent influencing factors for MACE occurrence.
Results Univariate analysis showed that the history of diabetes, multi vessel disease, left ventricular ejection fraction (LVEF)<50%, postoperative antiplatelet drug non-compliance, and postoperative low-density lipoprotein cholesterol (LDL-C) ≥ 1.8 mmol/L in the event group were higher than those in the non event group (P<0.05); Multifactor logistic regression analysis showed that the history of diabetes, multi vessel disease LVEF<50%、 Postoperative non-compliance with antiplatelet drugs and postoperative LDL-C ≥ 1.8mmol/L are independent risk factors for MACE in elderly patients with coronary heart disease after PCI (P<0.05).
Conclusion   The occurrence of MACE after PCI in elderly patients with coronary heart disease is closely related to the history of diabetes, multi vessel disease, cardiac dysfunction (LVEF<50%), postoperative antiplatelet non-compliance and poor blood lipid control. It is necessary to develop individualized intervention programs for these risk factors to reduce the risk of adverse events after surgery.