Shen W F, Cui L Q, Zhang J S, Wang M H, Gong L S, Lesbre J P
Department of Cardiology, Ruijin Hospital, Shanghai Second Medical University.
Chin Med J (Engl). 1991 Feb;104(2):142-8.
108 patients with acute myocardial infarction (MI), aged 70 years or younger, underwent left ventriculography and coronary arteriography (mean one month) after infarction and were followed up for an average period of 22 months (range 5-47 months). The contribution of angiographic variables to a first cardiac event (death, recurrent infarction, coronary artery bypass grafting or congestive heart failure) was evaluated with Kaplan-Meier survival curve analysis and long-rank test. Patients with cardiac events had left ventricular dilation, systolic dysfunction, multivessel coronary disease and lack of residual flow to the infarct region. Multivariate analysis showed that left ventricular end-systolic volume (P less than 0.001), end-diastolic volume (P less than 0.01) and the number of the diseased coronary vessels (P less than 0.05) were of significance in predicting the outcome. This prospective study indicates that in survivors of first acute transmural MI, cardiac catheterization performed one month after infarction can provide additive prognostic information that can be used to stratify risk.
108名年龄在70岁及以下的急性心肌梗死（MI）患者在梗死发生后接受了左心室造影和冠状动脉造影（平均在梗死后1个月），并进行了平均22个月（范围为5 - 47个月）的随访。采用Kaplan - Meier生存曲线分析和长秩检验评估血管造影变量对首次心脏事件（死亡、再发梗死、冠状动脉搭桥术或充血性心力衰竭）的影响。发生心脏事件的患者存在左心室扩张、收缩功能障碍、多支冠状动脉病变以及梗死区域无残余血流。多变量分析显示，左心室收缩末期容积（P < 0.001）、舒张末期容积（P < 0.01）和病变冠状动脉支数（P < 0.05）对预测预后具有重要意义。这项前瞻性研究表明，在首次急性透壁性心肌梗死的存活者中，梗死后1个月进行的心导管检查可提供额外的预后信息，用于风险分层。
