实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (4): 352-355.doi: 10.3969/j.issn.1003-9198.2023.04.008

• 临床研究 • 上一篇    下一篇

焦虑对老年经皮冠状动脉介入治疗术后病人不良心血管事件的预测价值

宋春梅, 尹亚娟, 刘永升, 郭岐峰, 陈洁, 魏梅   

  1. 066099 河北省秦皇岛市,秦皇岛市第一医院CCU2科(宋春梅);
    050031 河北省石家庄市,河北医科大学第一医院心脏中心(尹亚娟,郭岐峰,陈洁,魏梅);全科医学科(刘永升)
  • 收稿日期:2022-05-05 出版日期:2023-04-20 发布日期:2023-03-31
  • 通讯作者: 魏梅,Email:mei491458@sina.com
  • 基金资助:
    河北省自然科学基金资助项目(H2021206217);河北省医学科学研究课题计划(20201152,20210051);2020年省直医疗卫生机构老年病防治项目(LNB202013)

Predictive value of anxiety on adverse cardiovascular events in elderly patients after percutaneous coronary intervention

SONG Chun-mei, YIN Ya-juan, LIU Yong-sheng, GUO Qi-feng, CHEN Jie, WEI Mei   

  1. CCU2 Department, the First Hospital of Qinhuangdao, Qinhuangdao 066099, China(SONG Chun-mei);
    Heart Center(YIN Ya-juan, GUO Qi-feng, CHEN Jie, WEI Mei); Department of General Practice(LIU Yong-sheng), the First Hospital of Hebei Medical University, Shijiazhuang 050031, China
  • Received:2022-05-05 Online:2023-04-20 Published:2023-03-31
  • Contact: WEI Mei, Email: mei491458@sina.com

PDF (PC)

676

摘要： 目的 研究焦虑对接受经皮冠状动脉介入治疗(PCI)的老年冠心病病人主要不良心血管事件(MACE)的预测价值。方法 纳入681例年龄≥65岁老年PCI术后病人进行随访研究。收集病人的临床资料,采用汉密尔顿焦虑量表(HAMA)评价老年PCI术后病人的焦虑情况,统计出院后MACE发生情况,包括心源性死亡、非致死性心肌梗死、因心绞痛再次住院治疗、心力衰竭发作。结果 失访96例,最终共585例病人完成随访,平均随访时间为(28.34±10.07)个月。随访期间共85例病人发生MACE。MACE组病人的HAMA评分显著高于非MACE组,吸烟史、高血压、糖尿病、稳定型心绞痛(SAP)病人比例均高于非MACE组,年龄、不稳定型心绞痛(UAP)及急性心肌梗死(AMI)比例低于非MACE组(P<0.05或P<0.01)。ROC曲线分析表明,HAMA评分是老年PCI术后病人MACE风险的一个相对较强的预测因子,AUC为0.736(95%CI:0.661~0.812,P<0.001)。多因素Cox比例风险回归模型分析显示,年龄、HAMA评分、吸烟、糖尿病、冠心病家族史是老年PCI术后病人发生MACE的独立影响因素。结论 焦虑是老年PCI术后病人发生MACE的独立影响因素,且对老年PCI术后病人MACE风险存在一定预测价值。

关键词: 焦虑, 经皮冠状动脉介入治疗, 老年人, 主要不良心血管事件, 冠心病

Abstract: Objective To investigate the predictive value of anxiety on major adverse cardiovascular events (MACE) in the elderly patients with coronary heart disease(CHD) after percutaneous coronary intervention (PCI). Methods A total of 681 patients aged≥65 years undergoing PCI were enrolled in the study. The clinical data of the patients were collected. Hamilton Anxiety Scale (HAMA) was used to evaluate the anxiety of the patients. The incidence rate of MACE after discharge was recorded. MACE included cardiac death, nonfatal myocardial infarction, re-hospitalization for angina and heart failure. Results There were 96 patients dropping out and 585 patients completing the follow-up, finally. The mean follow-up time was 28.34±10.07 months. MACE occurred in 85 patients during the follow-up. There were significant differences in age, HAMA score and the proportion of smoking, hypertension, diabetes and CHD with different types between MACE group and non-MACE group(P<0.05 or P<0.01). Receiver operating characteristic (ROC) curve analysis showed that HAMA score was a relatively strong predictor of MACE in the elderly patients after PCI, and the area under the curve (AUC) was 0.736 (95%CI: 0.661-0.812, P<0.001). Multivariate Cox proportional risk regression model analysis showed that HAMA score, smoking, diabetes and family history of CHD were the independent risk factors for MACE in the elderly patients after PCI. Conclusions Anxiety is an independent risk factor for MACE in the elderly patients after PCI, and it has a certain predictive value for MACE in those patients.

Key words: anxiety, percutaneous coronary intervention, aged, major adverse cardiovascular events, coronary heard disease

中图分类号: