Long‐term Clinical Follow‐up in Patients With Angiographic Restudy After Successful Angioplasty
Long‐term Clinical Follow‐up in Patients With Angiographic Restudy After Successful Angioplasty
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成功血管成形术后进行血管造影再研究的患者的长期临床随访
DOI：
10.1161/01.cir.87.3.831
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发表时间：
1993
期刊：
影响因子：
37.8
通讯作者：
S. King
中科院分区：
文献类型：
--
作者：
W. Weintraub;Z. Ghazzal;J. Douglas;H. Liberman;D. Morris;C. Cohen;S. King
背景冠状动脉成形术后的呼吸仍然是一个关键的限制。很少有资料比较长期预后的患者谁遭受再狭窄和其他人谁没有。本文的目的是确定再狭窄或再研究冠状动脉造影记录的持续通畅患者的临床事件。方法与结果数据来源于埃默里大学的临床数据库。排除了既往接受过冠状动脉手术的患者和在急性心肌梗死情况下接受血管成形术的患者。共有3,363例患者在血管成形术后4个月至1年接受血管造影再研究，并与3,858例未接受再研究的患者进行了比较。在再研究人群中，1，570例发生再狭窄，1，793例在所有扩张部位动脉通畅。再狭窄患者年龄较大，高血压、糖尿病、心绞痛、多支冠状动脉病变、狭窄程度较重，原始结果较差。再研究时，无再狭窄患者中38.7%有心绞痛，而再狭窄患者中70.7%有心绞痛（p<0.0001）。前6个月死亡人数很少。6年时，无再狭窄的生存率为0.95，有再狭窄的生存率为0.93（p=0.16）。在6个月和6年时，无心肌梗死率分别为0.97和0.88（无再狭窄），0.93和0.85（有再狭窄）（p=0.0001）。在多变量分析中，再狭窄是心肌梗死的独立相关因素，但与死亡率无关。在6个月和6年时，无冠状动脉搭桥手术率分别为0.99和0.94，无再狭窄率分别为0.91和0.78（p<0.0001）。在6个月和6年时，无重复血管成形术的比率分别为0.96和0.76（无再狭窄）以及0.44和0.20（有再狭窄）（p=0.0001）。再狭窄伴复发性胸痛患者的事件发生率最高。未接受再研究的患者与研究组略有不同，未接受再研究的患者中重复血运重建手术要少得多。结论再狭窄患者更易发生心绞痛复发。尽管在生存率方面没有或只有很小的差异，但在有和无再狭窄的患者中心肌梗死率存在差异。再狭窄组的心肌梗死率和死亡率较低，可能与这些患者的重复血运重建有关;再狭窄人群的主要事件是频繁重复血运重建手术。
BackgroundRestenosis remains a critical limitation after coronary angioplasty. There is little information comparing long-term prognosis in patients who suffer from restenosis and others who do not. The purpose of this paper is to determine the clinical events in patients with restenosis or continued patency documented by restudy coronary arteriography. Methods and ResultsThe source of data was the clinical data base at Emory University. Patients who had previous coronary surgery and patients who underwent angioplasty in the setting of acute myocardial infarction were excluded. A total of 3,363 patients undergoing angiographic restudy 4 months to 1 year after angioplasty were compared with 3,858 not undergoing restudy. In the restudy population, 1,570 had restenosis and 1,793 had patent arteries at all sites dilated. The restenosis patients were older and had more hypertension, more diabetes, more severe angina, more multivessel coronary artery disease, more severe stenoses, and less satisfactory original results. At restudy, in patients without restenosis, 38.7% had angina versus 70.7% in patients with restenosis (p<0.0001). There were few deaths in the first 6 months. At 6 years, the survival rate was 0.95 without restenosis and 0.93 with restenosis (p=0.16). At 6 months and 6 years, freedom from myocardial infarction was 0.97 and 0.88 without restenosis and 0.93 and 0.85 with restenosis (p=0.0001). On multivariate analysis, restenosis was an independent correlate of myocardial infarction but not mortality. At 6 months and 6 years, freedom from coronary bypass surgery was 0.99 and 0.94 without restenosis and 0.91 and 0.78 with restenosis (p<0.0001). At 6 months and 6 years, freedom from repeat angioplasty was 0.96 and 0.76 without restenosis and 0.44 and 0.20 with restenosis (p=0.0001). The highest event rates were noted in the patients with restenosis with recurrent chest pain. Patients not undergoing restudy differed somewhat from the study group, and there were far fewer repeat revascularization procedures in the group not undergoing restudy. ConclusionsPatients with restenosis are more likely to have recurrent angina pectoris. Although there is no or little difference in survival, there is a difference in myocardial infarction rate in the patients with and without restenosis. The low myocardial infarction and death rates in the group suffering restenosis may be related to repeat revascularization in these patients; the principal events in the restenosis population are frequent repeat revascularization procedures.
影响因子：
37.8
作者：
K. Detre;R. Holubkov;S. Kelsey;M. Bourassa;David Williams;David Holmes;G. Dorros;D. Faxon;Richard Myler;Kenneth Kent;Michael Cowley;Richard Cannon;Thomas Robertson
通讯作者：
K. Detre;R. Holubkov;S. Kelsey;M. Bourassa;David Williams;David Holmes;G. Dorros;D. Faxon;Richard Myler;Kenneth Kent;Michael Cowley;Richard Cannon;Thomas Robertson
重复经皮腔内冠状动脉成形术和复发性再狭窄的预测因素。
DOI：
10.1016/0002-9149(89)90309-3
发表时间：
1989
期刊：
The American journal of cardiology
影响因子：
--
作者：
Quigley,PJ;Hlatky,MA;Hinohara,T;Rendall,DS;Perez,JA;Phillips,HR;Califf,RM;Stack,RS
通讯作者：
Stack,RS