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ȣ - 540140 312 |
| The changes of clinical patterns in elderly patients who underwent percutaneous coronary intervention during the last ten years |
| 전남대학교병원 순환기내과, 보건복지가족부지정 심장질환특성화 연구센터 |
| 김민석, 정명호, 황승환, 고점석, 이민구, 심두선, 박근호, 윤남식, 윤현주, 김계훈, 홍영준, 김주한, 안영근, 조정관, 박종춘, 강정채 |
Background/Aims: The prevalence of ischemic heart diseases in elderly Korean has been increased rapidly. The objective of this study is to observe the changes in the clinical patterns of Korean patients over the age of 65 years who received percutaneous coronary intervention (PCI) in the recent 10 years.
Methods: 3,209 patients over 65 years [male:female 1950 (71.4±5.21 years) : 1259 (72.5±5.47 years)] who underwent PCI between June 1999 and June 2009 were divided into 4 groups according to time period. Clinical characteristics, gender differences, coronary angiographic findings and major adverse cardiac events (MACE) during one-year clinical follow-up were compared among 4 groups.
Results: The gender ratio of the elderly subjects who underwent PCI during the last ten years was male dominant and no significant change was observed over a period of time [male (60.8%) : female (39.2%)], but the mean age increased consistently [1999-2001:2008-2009=71.2±5.11 years:72.6±5.57 years, p=0.001]. The prevalence of hypertension increased over the time (p=0.028), but smoking decreased (p=0.002). Hypertension was the major risk factor for male, and obesity for female patients. MACE-free one-year survival increased over the observed period (p=0.014). Male had higher survival rate than female (p=0.007). MACE developed in 105 (3.27%) patients within one year after PCI. Predictive factors for the development of MACE were female (p=0.001), old age (≧75 years) (p=0.008), hypertension (p=0.049), diabetes mellitus (p=0.004) and smoking (p=0.009), and low Thrombolysis In Myocardial Infarction (TIMI) flow after PCI (p=0.048) by multivariable analysis.
Conclusions: The age of the elderly patients undergoing PCI increased, and the prevalence of hypertension increased, and smoking decreased over the last 10 years. Patients with MACE during one-year follow-up were associated with female sex, high prevalence of hypertension, diabetes mellitus and smoking, older age, and low TIMI flow.
Key Words: Aged; Risk factor; Myocardial ischemia; Coronary disease; Coronary angioplasty
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