Sato I, Nishijima H, Matsumura N, Nishida M, Okita K, Yasuda H
Department of Cardiovascular Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Am Heart J. 1992 Jun;123(6):1510-5. doi: 10.1016/0002-8703(92)90802-3.
The incidence of cardiac events in Japanese men (mean age 54 +/- 10 years) with atypical or nonanginal chest pain was assessed prospectively. Three groups of patients, those with typical angina (TA; n = 134), those with atypical angina (AA; n = 192), and those with nonanginal chest pain (NA; n = 311) were studied with regard to cardiac events (cardiac death or nonfatal myocardial infarction), risk factors, and results of exercise testing. The total cholesterol and high-density lipoprotein-cholesterol levels were significantly different among the three groups, but no differences were observed for other risk factors. The incidences of cardiac events were 8.5%, 2.2%, and 1.3% in the TA, AA, and NA groups, respectively (p less than 0.05) during 3.2 +/- 1.5 years. Significant ST segment changes were observed in 70.1%, 25.5%, and 18.0% of the patients in the TA, AA, and NA groups, respectively, at the time of enrollment. The risk ratio for cardiac events in a positive exercise test was 1.7 (difference not significant) for the TA group and 6.1 (p less than 0.05) for the others combined (AA and NA groups). The risk ratio adjusted for risk factors (Cox model) was 2.2 (difference not significant) for the TA group and 4.9 (p less than 0.05) for the AA and NA groups combined. In conclusion, the incidence of cardiac events in those with AA or NA chest pain was relatively low in Japan, but the independent prognostic significance of positive exercise testing was demonstrated in this group of patients.
对患有非典型或非心绞痛性胸痛的日本男性（平均年龄54±10岁）的心脏事件发生率进行了前瞻性评估。研究了三组患者，即典型心绞痛患者（TA；n = 134）、非典型心绞痛患者（AA；n = 192）和非心绞痛性胸痛患者（NA；n = 311）的心脏事件（心源性死亡或非致命性心肌梗死）、危险因素及运动试验结果。三组患者的总胆固醇和高密度脂蛋白胆固醇水平存在显著差异，但其他危险因素未观察到差异。在3.2±1.5年期间，TA、AA和NA组的心脏事件发生率分别为8.5%、2.2%和1.3%（p<0.05）。在入组时，TA、AA和NA组分别有70.1%、25.5%和18.0%的患者观察到显著的ST段改变。TA组运动试验阳性时心脏事件的风险比为1.7（差异无统计学意义），其他两组（AA和NA组）合并后的风险比为6.1（p<0.05）。经危险因素调整后的风险比（Cox模型），TA组为2.2（差异无统计学意义），AA和NA组合并后为4.9（p<0.05）。总之，在日本，患有AA或NA胸痛的患者心脏事件发生率相对较低，但在这组患者中证实了运动试验阳性具有独立的预后意义。
