OBJECTIVE: We assessed clinical outcomes after PCI for ULMD and the impact of GNRI in elderly patients.
METHODS: We identified 669 non dialysis patients treated with current generation drug-eluting stent for ULMD from MITO registry. We divided the patients to the following 2 groups; elderly group (n = 240, age ≥75) and young group (n = 429, age <75). Additionally, we could calculate GNRI and divided elderly group into 2 group based on the median value of the GNRI. The primary endpoint was all-cause mortality.
RESULTS: All-cause mortality was significantly higher in elderly group [adjusted hazard ratio (HR) 2.37; 95% confidence interval (CI), 1.40-4.02; p = 0.001]. All-cause mortality was significantly higher in low GNRI elderly group compared to other 2 groups (Adjusted HR of elderly with low GNRI: 3.56, 95%CI (1.77-7.14), p < 0.001). Cardiovascular mortality was comparable between two groups. TLR rate was significantly lower in elderly group (adjusted HR 0.57; 95% CI, 0.34-0.97; p = 0.035).
CONCLUSIONS: The elderly had higher all-cause mortality after PCI for ULMD compared to young people. Especially, the elderly with low GNRI were extremely associated with poorer outcomes.
目的:我们评估老年患者ULMDPCI后的临床结局和GNRI的影响。
方法:我们从MITO注册中确定了669例非透析患者接受了ULMD的当前一代药物洗脱支架治疗。我们将患者分为以下2组:老年组(n=240,年龄≥75)和青年组(n=429,年龄<75)。此外,我们可以计算GNRI,并根据GNRI的中位数将老年组分为2组。主要终点是全因死亡率。
结果:老年组的全因死亡率明显高于[调整后的风险比(HR)2.37;95%置信区间(CI),1.40-4.02;p=0.001]。与其他两组相比,低GNRI老年人组的全因死亡率显着升高(低GNRI老年人的调整后HR:3.56,95CI(1.77-7.14),p<0.001)。两组的心血管死亡率相当。老年组TLR率显着降低(校正HR0.57;95%CI,0.34-0.97;p=0.035)。
结论:与年轻人相比,老年人因ULMDPCI术后全因死亡率较高。尤其是,GNRI较低的老年人与较差的结局极为相关.