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To analyze the clinical character of CABG (coronary artery bypass graft surgery), PCI (percutaneous coronary intervention) and medical therapy for patients with CAD (coronary heart disease) in the real clinical practice.
This is a multicenter, retrospective trial to analyze of the Clinical Character of PCI, CABG and medical therapy for patients with CAD between January 2003 and December 2011. All patients were consecutively enrolled in this study. The clinical data in hospitalization were recorded, and clinical events were followed up.
1, 8,770 patients with CAD were enrolled and 1018 patients (10.4%) were excluded. 469 patients (5.34%) had stable angina pectoris, 6010 patients (68.5%) had unstable angina pectoris, 790 patients (9.0%) had non-ST segment elevation myocardial infarction, and 1,501 patients (17.1%) had ST segment elevation myocardial infarction.
2, The proportion of CAD patients managed by PCI is 55.0%(4842/8770). The proportion of patients in the years of 2003-2005, 2006-2008, 2009-2011 managed by PCI is 38.6%, 59.9% and 58.9%. In 2011, the proportion of CAD patients managed by PCI is 64.9%. The proportion of patients with SAP, UAP, NSTEACS and STEMI managed by PCI is 48%(225/469), 50.7%(3448/6800) and 77.9%(1169/1501) respectively. 56.7% of STEMI were treated by emergency PCI.
3, The proportion of patients with left main disease, triple vessel disease and diabetes managed by PCI was 43.5% (337/777), 65.0% (1732/2663) and 52.2% (1266/2427).
4, The rates of patients using Clopidogrel, Aspirin, Statin and ACEI/ARB were 44.7%, 74.7%, 78.6%, 36.2% and 21.0% respectively.
1, As only 5.34% patients were diagnosed as stable angina pectoris patients, there is possible over diagnosis as unstable angina pectoris.
2, PCI is the main way to treat CAD and there is an upward trend of applying this technique.
3, The proportion of patients with LMD, TVD and diabetes managed by PCI was higher than those managed by PCI and medication significantly. And there is a great gap between the guidline and the clinical practice.
4, The compliance of all patients with evidence-based medication should be improved.