Causes of deaths in patients with cardiovascular diseases in era of revascularization
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(Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing 100853, China)

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R541

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    Abstract:

    Objective To investigate the causes of death in patients with cardiovascular diseases in era of revascularization. Methods The consecutive patients were recruited in the study, who underwent coronary angiography (CAG) in the Department of Cardiology of Chinese PLA General Hospital from 2008 to 2014. They were divided into three groups based on CAG:the coronary artery bypass graft (CABG) group, the optimized medication (OMT) group, and the percutaneous coronary intervention (PCI) group. From 2017, they were followed up by telephone calls, case record screening and outpatient visits, the death being the endpoint of follow-up. The causes of all deaths were analyzed, and the three groups were compared. Statistical analysis was performed using SPSS statistics 19.0. Results Of the 1 645 patients recruited, 113 died during the follow-up, with 28 (24.78%) in CABG group, 22 (19.47%) in OMT group, and 63 (55.75%) in PCI group, and differences being not statistically significant (P>0.05). Except for the Syntax score, the basic clinical data of the deaths did not differ significantly among the three groups (P> 0.05). From the highest to the lowest, Syntax score was (33.45±17.89) points in CABG group, (31.23±12.99) points in OMT group, and (21.35±11.65) points in PCI group. The rate of death cause was, from the highest to the lowest, acute myocardial infarction 40 (35.40%), sudden death 21 (18.58%), cancer 17 (15.04%), heart failure 14 (12.39%), multiple organ failure 11 (9.73%), cerebrovascular accident 6 (5.31%), stent thrombosis 3 (2.65%), and bleeding 1(0.88%). The deaths caused by acute myocardial infarction and sudden death were higher in PCI group than in the other two groups, but the difference was not statistically significant (P>0.05). Non-cardiovascular deaths caused by cancer and cerebrovascular accidents accounted for 21.12%; delayed cardiovascular deaths caused by heart failure and multiple organ failure accounted for 22.1%; and accidental deaths including sudden deaths and those caused by acute myocardial infarction and acute stent thrombosis accounted for 56.6%, the differences being of no statistical significant difference (P>0.05). Conclusion Acute myocardial infarction, sudden death and stent thrombosis are common after PCI. Cancer ranked the second as the cause of death. The patients with multiple organ failure and heart failure had poor prognosis. With the widespread use of antiplatelet drugs, anticoagulants and thrombolytics, cerebral hemorrhage deserves attention.

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History
  • Received:March 08,2020
  • Revised:
  • Adopted:
  • Online: January 04,2021
  • Published: