Clinical characteristics and long-term survival of patients with variant angina.
Clinical characteristics and long-term survival of patients with variant angina.
复制标题
变异型心绞痛患者的临床特征和长期生存。
DOI：
10.1161/01.cir.69.5.880
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发表时间：
1984
期刊：
影响因子：
37.8
通讯作者：
Rosati,RA
中科院分区：
文献类型：
--
作者：
Mark,DB;Califf,RM;Morris,KG;HarrellJr,FE;Pryor,DB;Hlatky,MA;Lee,KL;Rosati,RA
我们研究了109例变异型心绞痛患者，这些患者在11年的时间里接受了心导管检查。所有患者随访至少6个月或直至死亡，46例患者（22例药物治疗，24例手术治疗）随访5年或更长时间。在最初接受药物治疗的62例患者中，14例发生非致命性心肌梗死（12例在导管插入术后1个月内），12例死亡（6例在6个月内）。1年、3年和5年的生存概率分别为0.88、0.84和0.77。在48例手术治疗的患者中（包括4例最初接受药物治疗的患者和1例最初接受冠状动脉血管成形术治疗的患者），4例发生非致命性梗死（3例在围手术期），3例死亡（均在围手术期）。这些患者的1年生存概率为0.94，3年和5年时保持不变。手术治疗组患者出院后仅发生1例非致死性梗死，无死亡病例。另外3名患者接受了冠状动脉血管成形术治疗。在药物治疗的患者中，最重要的一个预后因素是是否存在固定的阻塞性冠状动脉疾病。23例无明显冠状动脉疾病患者的1年和3年无冠状动脉栓塞生存概率分别为1.0和0.89，而39例有明显冠状动脉疾病患者的1年和3年无冠状动脉栓塞生存概率分别为0.51和0.46。考克斯模型分析表明，如果其他重要的预后变量保持不变，变异型心绞痛患者比非变异型心绞痛冠心病患者有更高的死亡和非致死性梗死概率。（250字处删节）
We studied 109 consecutive patients with variant angina who underwent cardiac catheterization over an 11 year period. All patients were followed for at least 6 months or until death, and 46 patients (22 treated medically and 24 treated surgically) were followed for 5 years or more. Of the 62 patients initially treated medically, 14 had nonfatal myocardial infarctions (12 within 1 month of catheterization) and 12 died (six within 6 months). Survival probabilities at 1, 3, and 5 years were 0.88, 0.84, and 0.77, respectively. Of the 48 surgically treated patients (including four patients initially treated medically and one initially treated with coronary angioplasty), four had nonfatal infarctions (three in the perioperative period) and three died (all in the perioperative period). The survival probability in these patients at 1 year was 0.94 and remained unchanged at 3 and 5 years. Only one nonfatal infarction and no deaths have occurred in the group of surgically treated patients subsequent to hospital discharge. Three additional patients were treated with coronary angioplasty. The single most important prognostic factor in medically treated patients was the presence or absence of fixed obstructive coronary artery disease. Infarction-free survival probabilities at 1 and 3 years in the 23 patients without significant coronary artery disease were 1.0 and 0.89, compared with 0.51 and 0.46 in the 39 patients with significant coronary disease. Analysis by the Cox model showed that variant angina patients had a higher probability of death and nonfatal infarction than did those with nonvariant angina coronary disease if other important prognostic variables were held constant.(ABSTRACT TRUNCATED AT 250 WORDS)