Lü Shuzheng, Liu Wenxian, Song Xiantao, Chen Yundai, Liu Hong, Chen Liying, Lu Yanling, Chen Xin, Tian Rui, Zhang Jinrong
Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Beijing 100029, China.
Chin Med J (Engl). 2003 Sep;116(9):1341-4.
To analyse the effects of different therapies on coronary artery disease (CAD).
A total of 1055 patients who suffered from CAD diagnosed by coronary angiography were divided into three groups, namely pure drug therapy, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) groups. Follow up was carried out from March to May in 2001, and the major adverse cardiac events (MACEs) including death, no-lethal myocardial infarction (MI) and revascularization were observed. In long-term observation, angina reoccurred, and their improvement was evaluated. The short-term period was defined as the duration of 30 days after discharge, and the long term period was defined as the duration from 30 days after discharge.
In the long-term period, the recurrences of angina both in PCI group and CABG group were lower than pure drug group (P 0.018, 0.002 respectively). No differences about long-term endpoint events were observed among these three groups (P > 0.05). Forty-two patients suffering from left main coronary disease were intervened by the three therapies, and there was no death or MI both in PCI and CABG groups, three patients died and suffered from AMI in pure drug therapy group (P = 0.015). In the short-term period, mortality in CABG group (5.77%) was higher than those in the other two groups (1.91% for PCI, and 1.40% for medical therapy, P = 0.002), and no obvious difference observed in the latter two groups. No significance was concluded about the recent MI among this three groups (P = 0.357). There were no differences on revascularization in these three groups.
Percutaneous coronary interventions can not only reduce the attack of angina but also improve the life quality of patients, however it can not improve the long-term existence but left main CAD.
分析不同治疗方法对冠状动脉疾病（CAD）的影响。
将1055例经冠状动脉造影确诊为CAD的患者分为三组，即单纯药物治疗组、经皮冠状动脉介入治疗（PCI）组和冠状动脉旁路移植术（CABG）组。于2001年3月至5月进行随访，观察主要不良心脏事件（MACE），包括死亡、非致死性心肌梗死（MI）和血运重建。在长期观察中，观察心绞痛复发情况并评估其改善情况。短期定义为出院后30天，长期定义为出院后30天以后。
长期来看，PCI组和CABG组心绞痛复发率均低于单纯药物治疗组（分别为P = 0.018、0.002）。三组间长期终点事件无差异（P>0.05）。42例左主干冠状动脉疾病患者接受了三种治疗，PCI组和CABG组均无死亡或MI发生，单纯药物治疗组有3例患者死亡并发生急性心肌梗死（P = 0.015）。短期内，CABG组死亡率（5.77%）高于其他两组（PCI组为1.91%，药物治疗组为1.40%，P = 0.002），后两组间无明显差异。三组近期MI无统计学意义（P = 0.357）。三组血运重建无差异。
经皮冠状动脉介入治疗不仅可减少心绞痛发作，还可改善患者生活质量，但不能改善长期生存率，对左主干CAD除外。
