Anderson H V, Talley J D, Black A J, Roubin G S, Douglas J S, King S B
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Am J Cardiol. 1990 Jan 1;65(1):35-9. doi: 10.1016/0002-9149(90)90022-s.
Of 6,545 patients who had elective coronary angioplasty procedures performed over a 7.5-year period from June 1980 through December 1987, 114 (1.7%) never had symptoms of myocardial ischemia. Exercise-induced silent myocardial ischemia was documented before angioplasty in 94% of these asymptomatic patients. Angioplasty was successful in 87%, whereas emergency coronary artery bypass grafting was required in 4%, and a further 2% had myocardial infarctions after the procedures. The remaining 7% had unsuccessful angioplasty procedures but experienced no in-hospital cardiac events. The follow-up period after hospital discharge averaged 43 +/- 20 months (range 5 to 93). There were no deaths. In the group of 99 patients with initially successful angioplasty procedures the follow-up interval ranged from 5 to 92 months. During that period, 7 patients underwent coronary bypass surgery, 4 patients had myocardial infarction and 30 patients had repeat angioplasty procedures for restenosis. The cumulative probability of event-free survival over 5 years for the group with successful angioplasty was: 100% freedom from death, 95% freedom from myocardial infarction, 87% freedom from myocardial infarction or coronary bypass surgery and 61% freedom from myocardial infarction, coronary bypass surgery or repeat angioplasty. Thus, coronary angioplasty performed in 114 asymptomatic patients, most with exercise-induced silent myocardial ischemia, achieved very good primary success and was accompanied by low cardiac event rates and no deaths over several years of patient follow-up.
在1980年6月至1987年12月的7.5年期间接受选择性冠状动脉血管成形术的6545例患者中，114例（1.7%）从未出现过心肌缺血症状。这些无症状患者中，94%在血管成形术前记录到运动诱发的无症状心肌缺血。血管成形术成功率为87%，4%的患者需要进行急诊冠状动脉旁路移植术，另有2%的患者术后发生心肌梗死。其余7%的患者血管成形术未成功，但未发生院内心脏事件。出院后的随访期平均为43±20个月（范围5至93个月）。无死亡病例。在最初血管成形术成功的99例患者中，随访间隔为5至92个月。在此期间，7例患者接受了冠状动脉旁路手术，4例患者发生心肌梗死，30例患者因再狭窄接受了重复血管成形术。血管成形术成功组5年无事件生存的累积概率为：100%无死亡，95%无心肌梗死，87%无心肌梗死或冠状动脉旁路手术，61%无心肌梗死、冠状动脉旁路手术或重复血管成形术。因此，对114例无症状患者进行冠状动脉血管成形术，大多数患者有运动诱发的无症状心肌缺血，取得了很好的初次成功率，且在患者数年的随访中，心脏事件发生率低，无死亡病例。
