Coronary Artery Disease and Cardiac Events With Asymptomatic and Symptomatic Cerebrovascular Disease
Coronary Artery Disease and Cardiac Events With Asymptomatic and Symptomatic Cerebrovascular Disease
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冠状动脉疾病和无症状和有症状脑血管疾病的心脏事件
作者：
B. Love;M. Grover‐Mckay;J. Biller;K. Rezai;C. McKay
背景和目的本研究的目的是评估无症状颈动脉狭窄、短暂性脑缺血发作或小中风患者在随访期间冠状动脉疾病和冠状动脉事件的患病率。方法我们前瞻性地研究了连续60例患者，按照既定的方案进行了Tl-201核素扫描和冠状动脉造影术。结果15例无症状性颈动脉狭窄患者中有7例(47%)201TI异常，44例短暂性脑缺血发作或小卒中患者中有19例(43%)异常(p>；0.05)。在33例无冠状动脉病史的患者中，11例(33%)有可逆性201TI缺陷。在26例有冠状动脉病史的患者中，15例(58%)有可逆性和/或固定性缺损(与无冠脉病史的患者相比，p=0.054)。外周血管病史是与201TI试验异常显著相关的唯一危险因素(p=0.032)。在接受冠状动脉造影术的15名患者中，有14名患者在一条或多条血管中发现冠状动脉狭窄超过50%。在平均311天的随访期内，4名患者(7%)出现了新的心绞痛发作。14例患者中有4例(29%)发生冠状动脉事件，其中201TI显示可逆区，冠状动脉造影术异常。相比之下，在201TI的研究中，46名患者(9%)中只有4名患者(9%)发生了4起冠状动脉事件(p=0.055)。结论无冠心病病史患者中有1/3的患者201TI异常，有症状或无症状脑血管病患者中有近一半的患者201TI异常。具有可逆性201TI缺损者和冠状动脉造影术显示明显狭窄的患者发生后续心脏事件的风险更高。这些发现证明了对无症状和有症状的脑血管疾病患者进行心脏病筛查的有效性。
Background and Purpose The purpose of this study was to evaluate the prevalence of coronary artery disease and coronary events during follow-up in patients with asymptomatic carotid stenosis, transient ischemic attacks, or small strokes. Methods We prospectively studied 60 consecutive patients with thallium-201 scintigraphy followed by coronary arteriography according to an established protocol. Results The 201TI testing was abnormal in seven of 15 patients (47%) with asymptomatic carotid stenosis and in 19 of 44 patients (43%) with transient ischemic attacks or small strokes (p>0.05). In 33 patients with no history of coronary artery disease, 11 (33%) had reversible 201TI defects. In 26 patients with a history of coronary artery disease, 15 (58%) had reversible and/or fixed defects (p=0.054 compared with patients with no history). A history of peripheral vascular disease was the only risk factor significantly associated with an abnormal 201TI test (p=0.032). Coronary artery stenosis of greater than 50% was identified in one or more vessels in 14 of 15 patients undergoing coronary arteriography. Over a mean follow-up period of 311 days, four patients (7%) developed new onset of angina. There were four coronary events among 14 patients (29%) with both a reversible area on the 201TI and abnormal coronary arteriography. In comparison, there were only four coronary events among 46 patients (9%) without reversible defects on the 201TI studies (p=0.055). Conclusions Our study demonstrates that one third of patients with no history of coronary artery disease had an abnormal 201TI test and that nearly one half of patients with either symptomatic or asymptomatic cerebrovascular disease had abnormal 201TI tests. Patients with a reversible 201TI defect and significant stenosis by coronary arteriography were at higher risk for subsequent cardiac events. These findings demonstrate the utility of screening patients with asymptomatic and symptomatic cerebrovascular disease for cardiac disease.
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运动铊 201 试验对胸痛门诊患者的预后效用：与心导管插入术的比较。
影响因子：
37.8
作者：
Kaul,S;Lilly,DR;Gascho,JA;Watson,DD;Gibson,RS;Oliner,CA;Ryan,JM;Beller,GA
通讯作者：
Beller,GA
影响因子：
8.3
作者：
SACCO, RL;WOLF, PA;MCNAMARA, PM
通讯作者：
MCNAMARA, PM
影响因子：
37.8
作者：
LITTLE, WC;CONSTANTINESCU, M;SANTAMORE, WP
通讯作者：
SANTAMORE, WP
DOI：
--
发表时间：
1985
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
Ernest V. Garcia;K. V. Train;J. Maddahi;F. Prigent;J. Friedman;J. Areeda;A. Waxman;D. Berman
通讯作者：
Ernest V. Garcia;K. V. Train;J. Maddahi;F. Prigent;J. Friedman;J. Areeda;A. Waxman;D. Berman
双嘧达莫铊闪烁扫描评估缺血性心脏病的预后价值。
影响因子：
24
作者：
Hendel,RC;Layden,JJ;Leppo,JA
通讯作者：
Leppo,JA