ANGIOGRAPHIC PREVALENCE OF HIGH-RISK CORONARY-ARTERY DISEASE IN PATIENT SUBSETS (CASS)
ANGIOGRAPHIC PREVALENCE OF HIGH-RISK CORONARY-ARTERY DISEASE IN PATIENT SUBSETS (CASS)
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DOI：
10.1161/01.cir.64.2.360
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发表时间：
1981-01-01
期刊：
影响因子：
37.8
通讯作者：
KILLIP, T
中科院分区：
文献类型：
--
作者：
CHAITMAN, BR;BOURASSA, MG;KILLIP, T
冠状动脉狭窄的患病率。70%或左主干狭窄≥在冠状动脉手术研究中，对20，391例接受血管造影术的患者进行了50%的评价。排除不稳定型心绞痛或心肌梗死后，明确型心绞痛、可能型心绞痛和非特异性胸痛患者8157例，男性患病率分别为93%、66%和14%，女性患病率分别为72%、36%和6%（P < 0.001）。患者的年龄、性别和胸痛性质是影响疾病患病率和严重程度的重要因素。左主干或3支冠状动脉疾病发生在> 50%的中年男性和老年女性明确心绞痛和> 50%的男性谁有可能心绞痛和年龄超过60岁。在1282例男性和1397例女性非特异性胸痛患者中，无论年龄大小，左主干冠状动脉病变的发生率均< 2%和< 1%。在后一个患者子集中，60岁以下每十年有< 5%的男性和< 1%的女性患有左主干或3支血管冠状动脉疾病。高危冠心病常见于有明确心绞痛的中年患者和有可能心绞痛的老年患者，但在非特异性胸痛患者中罕见。这些结果可作为诊断性无创检查和冠状动脉造影的指征和指南。
The prevalence of coronary artery stenoses .gtoreq. 70% or left main stenosis .gtoreq. 50% was evaluated in 20,391 patients who underwent angiography in the Coronary Artery Surgery Study. After the patients with unstable angina or myocardial infarction were excluded, the disease prevalence in the 8157 patients with definite angina, probable angina and nonspecific chest pain was 93, 66 and 14% in men and 72, 36 and 6% in women, respectively (P < 0.001). The age and sex of the patients and character of chest pain were important determinants of disease prevalence and severity. Left main or 3-vessel coronary disease occurred in > 50% of middle-aged men and older women with definite angina and in > 50% of men who had probable angina and were older than 60 yr of age. Left main coronary disease occurred in < 2% of 1282 men and < 1% of 1397 women with nonspecific chest pain regardless of age. In this latter patient subset, < 5% of men and < 1% of women in each decade under 60 yr had left main or 3-vessel coronary artery disease. High-risk coronary disease is common in middle-aged patients with definite angina and older patients with probable angina, but is rare in patients with nonspecific chest pain. Indications and guidelines for diagnostic noninvasive tests and coronary angiography could be based on these results.