PROGNOSTIC-SIGNIFICANCE OF ANGIOGRAPHICALLY DOCUMENTED LEFT-VENTRICULAR ANEURYSM FROM THE CORONARY-ARTERY SURGERY STUDY (CASS)
PROGNOSTIC-SIGNIFICANCE OF ANGIOGRAPHICALLY DOCUMENTED LEFT-VENTRICULAR ANEURYSM FROM THE CORONARY-ARTERY SURGERY STUDY (CASS)
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DOI：
10.1016/0002-9149(82)90023-6
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发表时间：
1982-01-01
影响因子：
2.8
通讯作者：
TONG, TGL
中科院分区：
文献类型：
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作者：
FAXON, DP;RYAN, TJ;TONG, TGL
为了评估经血管造影确定的经药物治疗的左心室动脉瘤患者的预后，我们分析了冠状动脉外科研究（CASS）登记的15019名冠状动脉疾病患者中1136名动脉瘤患者（7.6%）的数据。既往心肌梗死、射血分数降低、无心绞痛和充血性心力衰竭的证据在动脉瘤患者中更为常见。经药物治疗的患者1年、2年、3年和4年的累计生存率分别为90%、84%、79%和71%。Cox生存分析表明，以下变量预测预后：年龄、血管造影评估的剩余左心室功能、左心室舒张末期压、充血性心力衰竭导致的功能损害、病变血管数量、二尖瓣反流和S3gallop。当对相似程度的左心室功能障碍和功能损害进行生存分层时，动脉瘤患者的生存与登记的无动脉瘤患者的生存没有差异。这项大规模人群研究的数据表明，左心室动脉瘤患者的生存率比以前认识到的要好。该组的死亡率主要与年龄、左心室功能和心力衰竭的临床严重程度有关。动脉瘤的存在并不会单独改变患者的生存。
In order to evaluate the prognosis of medically treated patients with angiographically defined left ventricular aneurysm the data available from 1,136 patients with aneurysm (7.6 percent) from 15,019 patients with coronary artery disease in the Coronary Artery Surgery Study (CASS) registry were analyzed. Prior myocardial infarction, reduced ejection fraction, absence of angina and evidence of congestive heart failure were more commonly present in patients with aneurysm. The cumulative survival rates of medically treated patients at 1, 2, 3 and 4 years were 90, 84, 79 and 71 percent, respectively. The Cox analysis of survival indicated that the following variables predicted outcome: age, residual left ventricular function as assessed with angiography, left ventricular end-diastolic pressure, functional impairment due to congestive heart failure, number of vessels diseased, mitral regurgitation and S3gallop. When survival was stratified for similar degrees of left ventricular dysfunction and functional impairment there was no difference between the survival of patients with aneurysm and that of registry patients without aneurysm.The data from this large population study indicate that the survival of patients with left ventricular aneurysm is better than previously recognized. The mortality in this group is primarily related to age, left ventricular function and clinical severity of heart failure. The presence of an aneurysm does not independently alter survival.