Deedwania P C, Carbajal E V
Department of Medicine, Veterans Affairs Medical Center, Fresno, Calif.
Arch Intern Med. 1991 Dec;151(12):2373-82.
Silent myocardial ischemia has been shown to occur far more frequently than anginal episodes in patients with coronary artery disease. Both an increase in myocardial oxygen demand and abnormalities of coronary vasomotor tone appear to play a significant role in the genesis of silent ischemia. Recent data show that in excess of 40% of patients with stable angina have frequent episodes of silent ischemia. The presence of silent ischemia predicts an increased risk of coronary events and cardiac death. Based on these data, it has been proposed that anti-ischemic therapy should be directed toward control of total ischemic burden. Although several recent studies have demonstrated efficacy of various antianginal drugs in reducing the number and duration of silent ischemic episodes, none has demonstrated beneficial effect on the associated adverse prognosis.
在冠心病患者中，无症状性心肌缺血的发生频率已被证明远高于心绞痛发作。心肌需氧量增加和冠状动脉血管舒缩功能异常似乎在无症状性缺血的发生中都起着重要作用。最近的数据表明，超过40%的稳定型心绞痛患者有频繁的无症状性缺血发作。无症状性缺血的存在预示着冠状动脉事件和心源性死亡风险增加。基于这些数据，有人提出抗缺血治疗应旨在控制总的缺血负荷。尽管最近的几项研究已证明各种抗心绞痛药物在减少无症状性缺血发作的次数和持续时间方面有效，但尚无研究表明其对相关不良预后有有益作用。
