Effects of Asymptomatic Ischemia on Long‐term Prognosis in Chronic Stable Coronary Disease
Effects of Asymptomatic Ischemia on Long‐term Prognosis in Chronic Stable Coronary Disease
复制标题
无症状缺血对慢性稳定性冠心病长期预后的影响
DOI：
10.1161/01.cir.83.5.1598
复制
发表时间：
1991
期刊：
影响因子：
37.8
通讯作者：
A. Selwyn
中科院分区：
文献类型：
--
作者：
A. Yeung;J. Barry;J. Orav;Edina Bonassin;K. Raby;A. Selwyn
背景动态心电图监测显示缺血对不稳定型心绞痛、心肌梗死后和慢性稳定型心绞痛患者的短期心功能有不良影响。方法和结果在这项长期研究中，我们随访了138例慢性稳定型心绞痛患者（平均年龄59±9岁），这些患者的心脏事件运动试验阳性（例如，死亡、心肌梗塞、经皮腔内冠状动脉成形术或冠状动脉旁路移植手术）。在105例患者中，在所有抗心绞痛药物停药48小时后进行动态心电图监测。在26名患者中，在常规药物治疗期间重复诊断测试。除105例患者外，33例患者仅在常规药物治疗期间进行监测。在37±17个月的随访期间，有9例死亡，9例心肌梗死和35例血运重建手术。在停药监测的患者中，考克斯生存分析显示，心电图监测的缺血发生是随后2年死亡和心肌梗死的最显著预测因素（p = 0.02），是5年所有不良事件的最显著预测因素（p = 0.009）。接受药物监测且无缺血的患者（n =18）出现的不良事件似乎多于接受药物监测但无缺血的患者（n =43）。结论：稳定型心绞痛患者动态心电图监测无症状性心肌缺血可预测2年内死亡和心肌梗死，并可预测5年内所有不良事件。在药物治疗期间进行的监测可能显示没有缺血;然而，这可能并不表明未来冠状动脉事件的风险较低。
BackgroundIschemia on ambulatory electrocardiographic monitoring has been shown to adversely affect short-term prognoses in patients with unstable angina, after myocardial infarction, and with chronic stable angina. Methods and ResultsIn this long-term study, we followed 138 patients (mean age, 59±9 years) with chronic stable angina and positive exercise tests for cardiac events (e.g., death, myocardial infarction, percutaneous transluminal coronary angioplasty, or coronary artery bypass graft surgery). In 105 patients, ambulatory electrocardiographic monitoring was performed after all antianginal medication was withheld for 48 hours. In 26 patients, the diagnostic tests were repeated while on their usual medication. In addition to the 105 patients, 33 patients had their monitoring performed only while on their usual medication. During 37±17 months of follow-up, there were nine deaths, nine myocardial infarctions, and 35 revascularization procedures. In patients monitored off medication, Cox survival analysis showed that the occurrence of ischemia on electrocardiographic monitoring was the most significant predictor of death and myocardial infarction in the subsequent 2 years (p = 0.02) and of all adverse events for 5 years p = 0.009). Patients who were monitored on medication and did not have ischemia (n =18) appeared to have more adverse events than patients who had no ischemia while being monitored off medication (n =43). ConclusionsAsymptomatic ischemia on ambulatory electrocardiographic monitoring in patients with stable angina predicts death and myocardial infarction for 2 years and all adverse events for 5 years. Monitoring performed while on medication may show no ischemia; however, this may not indicate low risk of future coronary events.
冠状动脉疾病门诊患者短暂性心肌缺血的变异性。
影响因子：
37.8
作者：
Nabel,EG;Barry,J;Rocco,MB;Campbell,S;Mead,K;Fenton,T;Orav,EJ;Selwyn,AP
通讯作者：
Selwyn,AP
影响因子：
37.8
作者：
LITTLE, WC;CONSTANTINESCU, M;SANTAMORE, WP
通讯作者：
SANTAMORE, WP