Arora R R, Platko W P, Bhadwar K, Simpfendorfer C
Department of Cardiology, Cleveland Clinic Foundation, Ohio.
Cathet Cardiovasc Diagn. 1989 Apr;16(4):226-9. doi: 10.1002/ccd.1810160404.
Coronary angiograms from 2,372 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were retrospectively reviewed for the presence of intracoronary thrombus (ICT) before dilatation. Patients with evolving acute myocardial infarction and those receiving thrombolytic therapy were excluded from analysis. Coronary artery thrombus was present in 126 patients (6%) (group 1). When compared to 2,246 patients (group 2) without ICT, group 1 had a higher incidence of unstable angina, 74% vs. 66% (less than 0.06), previous myocardial infarction, 59% vs. 37% (P less than .0001), and history of a recent myocardial infarction, 28% vs. 9% (P less than .0001). Patients with predilatation intracoronary thrombus had a higher risk for acute occlusion, 6% vs. 2% (P less than .002); however, the incidence of emergency coronary bypass surgery and myocardial infarction was similar in both groups. Therefore, the presence of predilatation intracoronary thrombus heralds an increased risk of acute occlusion, but not myocardial infarction or emergency coronary artery bypass surgery.
对2372例接受经皮腔内冠状动脉成形术（PTCA）的连续患者的冠状动脉造影进行回顾性分析，以确定扩张前冠状动脉内血栓（ICT）的存在情况。正在发生急性心肌梗死的患者和接受溶栓治疗的患者被排除在分析之外。126例患者（6%）存在冠状动脉血栓（第1组）。与2246例无ICT的患者（第2组）相比，第1组不稳定型心绞痛的发生率更高，分别为74%和66%（P<0.06），既往心肌梗死发生率分别为59%和37%（P<0.0001），近期心肌梗死病史发生率分别为28%和9%（P<0.0001）。扩张前冠状动脉内有血栓的患者急性闭塞风险更高，分别为6%和2%（P<0.002）；然而，两组急诊冠状动脉搭桥手术和心肌梗死的发生率相似。因此，扩张前冠状动脉内血栓的存在预示着急性闭塞风险增加，但不是心肌梗死或急诊冠状动脉搭桥手术的风险增加。
