PROGNOSTIC IMPORTANCE OF A CLINICAL PROFILE AND EXERCISE TEST IN MEDICALLY TREATED PATIENTS WITH CORONARY-ARTERY DISEASE
PROGNOSTIC IMPORTANCE OF A CLINICAL PROFILE AND EXERCISE TEST IN MEDICALLY TREATED PATIENTS WITH CORONARY-ARTERY DISEASE
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DOI：
10.1016/s0735-1097(84)80254-5
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发表时间：
1984-01-01
影响因子：
24
通讯作者：
TRISTANI, F
中科院分区：
文献类型：
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作者：
WEINER, DA;RYAN, TJ;TRISTANI, F
为了确定有症状的冠状动脉疾病患者的死亡率预测因素，我们对 4083 名患者的 30 个变量进行了分析。回归分析表明，七个变量是生存的独立预测因子。确定了一个高风险亚组（年死亡率高于 5%），由充血性心力衰竭评分为 3-4 或 1 毫米或 ST 段压低更大且最终运动阶段为 1 或更低的患者组成。当对所有 30 个变量进行联合分析时，左心室收缩模式 (P < 0.0001) 和病变冠状血管数量 (P < 0.003) 被证明是最重要的生存预测因素。在由 572 名患有 3 支冠状动脉疾病且保留左心室功能的患者组成的亚组中，4 年生存概率范围从只能达到 1/2 阶段运动的患者的 53% 到能够运动到 5 阶段的患者的 100%（P < 0.004）。对于冠状动脉病理解剖学明确的患者，主要与左心室功能状态相关的临床和运动变量有助于评估预后。
To identify predictors of mortality in medically treated patients with symptomatic coronary artery disease, 30 variables were analyzed in 4083 patients. Regression analysis demonstrated that seven variables were independent predictors of survival. A high risk subgroup (annual mortality rate above 5%) was identified, consisting of patients with either a congestive heart failure score of 3-4 or 1 mm or greater ST segment depression and final exercise stage of 1 or less. When all 30 variables were analyzed conjointly, the left ventricular contraction pattern (P < 0.0001) and the number of diseased coronary vessels (P < 0.003) proved to be the most important predictors of survival. In a subgroup of 572 patients with 3 vessel coronary disease and preserved left ventricular function, the probability of survival at 4 yr ranged from 53% for patients only able to achieve stage 1/2 of exercise to 100% for patients able to exercise into stage 5 (P < 0.004). In patients with defined coronary pathoanatomy, clinical and exercise variables primarily relating to the functional state of the left ventricle are helpful in assessing prognosis.