Fukumura Y, Kataoka Y, Nakai Y, Bando M, Otani R, Hamai K, Wada T, Hiasa Y, Aihara T
Department of Cardiology, Komatsushima Red Cross Hospital.
Kyobu Geka. 1990 May;43(5):364-7.
Selective coronary angiography to determine the prevalence of coronary artery disease (CAD) has been performed in patients with abdominal aortic aneurysm (AAA). Thirty patients in this series consisted of 26 men and 4 women with an age range of 48-87 years (mean +/- SD: 67.5 +/- 8.2 years). As the atherosclerotic risk factors, cigarette smoking was present in 19 patients (63.3%), hypertension was in 18 (60%), hypercholesteremia was in 10 (33.3%), and diabetes mellitus was in 2 (6.7%). Cerebral vascular disease was present in 11 patients (36.7%). Regarding CAD, angina pectoris or old myocardial infarction was found in 9 patients (30%), and abnormal electrocardiography (ECG) was in 16 patients (53.3%). Coronary angiography prior to operation of AAA was performed to 22 patients (73.3%), and 15 patients (68.2%) among them had significant coronary artery stenosis, and 9 patients underwent myocardial revascularization (4 CABG, 5 PTCA). CAD was frequently complicated both in patients without symptoms or ECG abnormalities and in less than 65-year patients. In order to prevent fatal myocardial infarction, we recommend routine coronary angiography to patients with AAA. And if necessary, myocardial revascularization must be indicated prior to aneurysmectomy.
已对腹主动脉瘤（AAA）患者进行选择性冠状动脉造影以确定冠状动脉疾病（CAD）的患病率。本系列的30例患者包括26名男性和4名女性，年龄范围为48 - 87岁（平均±标准差：67.5±8.2岁）。作为动脉粥样硬化危险因素，19例患者（63.3%）有吸烟史，18例（60%）有高血压，10例（33.3%）有高胆固醇血症，2例（6.7%）有糖尿病。11例患者（36.7%）有脑血管疾病。关于CAD，9例患者（30%）发现有心绞痛或陈旧性心肌梗死，16例患者（53.3%）心电图（ECG）异常。22例患者（73.3%）在AAA手术前进行了冠状动脉造影，其中15例患者（68.2%）有明显冠状动脉狭窄，9例患者接受了心肌血运重建（4例冠状动脉旁路移植术，5例经皮冠状动脉腔内血管成形术）。CAD在无症状或ECG无异常的患者以及年龄小于65岁的患者中经常并发。为预防致命性心肌梗死，我们建议对AAA患者进行常规冠状动脉造影。如有必要，在动脉瘤切除术前必须进行心肌血运重建。
