SURVIVAL IN MEDICALLY TREATED CORONARY-ARTERY DISEASE
SURVIVAL IN MEDICALLY TREATED CORONARY-ARTERY DISEASE
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DOI：
10.1161/01.cir.60.6.1259
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发表时间：
1979-01-01
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：
HARRIS, PJ;HARRELL, FE;ROSATI, RA
在1214例有症状的经药物治疗的冠状动脉疾病患者中，通过多变量分析技术分析了57个无创基线临床特征和24个导管插入术描述符，以确定作为生存率独立预测因子的特征，并确定除了导管插入术结果外，无创特征是否有助于预后信息。当分析非侵入性特征时，31个特征是显著的（P < 0.05）生存的单变量预测因子，但只有12个包含显著的独立预后信息。197例无独立显著非侵入性特征的患者的5年和7年生存率均为90%。19个变量是显着的导管插入术的描述符进行了单独分析。只有7个是独立的显着时，他们联合分析。当对所有81个基线特征进行联合分析时，（外周血管疾病史、纽约心脏协会IV级心力衰竭、非特异性心室内传导缺陷、进行性胸痛、夜间疼痛、静息心电图室性早搏和左束分支传导阻滞）和6个侵入性特征（左主干狭窄、动静脉氧分压差、病变血管数、左室收缩异常、左室舒张末压和前壁不同步）独立显著。不同的存活率可能发生在仅关于1个或2个重要特征（例如，冠状动脉解剖结构和心室功能），因为在其他重要的基线特征的差异。无创性和有创性的特点必须考虑到充分界定冠心病的预后。
In 1214 symptomatic medically treated patients with coronary artery disease, 57 noninvasive baseline clinical characteristics and 24 catheterization descriptors were analyzed by a multivariable analysis technique to determine the characteristics that were independent predictors of survival, and to determine whether noninvasive characteristics contributed prognostic information in addition to catheterization findings. When the noninvasive characteristics were analyzed, 31 characteristics were significant (P < 0.05) univariate predictors of survival, but only 12 contained significant independent prognostic information. Five and 7 yr survival rates in 197 patients who had none of the independently significant noninvasive characteristics were both 90%. Nineteen variables were significant when the catheterization descriptors were analyzed individually. Only 7 were independently significant when they were analyzed jointly. When all 81 baseline characteristics were analyzed jointly, 7 noninvasive characteristics (history of peripheral vascular disease, New York Heart Association class IV heart failure, nonspecific intraventricular conduction defect, progressive chest pain, nocturnal pain, premature ventricular complexes on the resting ECG, and left bundle branch block) and 6 invasive characteristics (left-main stenosis, arteriovenous O2 difference, number of diseased vessels, abnormal left ventricular contraction, left ventricular end-diastolic pressure and anterior asynergy) were independently significant. Different survival rates may occur in subsets that are uniform with respect to only 1 or 2 important characteristics (e.g., coronary anatomy and ventricular function) because of differences in other important baseline characteristics. Both noninvasive and invasive characteristics must be taken into account to fully define prognosis in coronary disease.