Kamp O, Beatt K J, De Feyter P J, van den Brand M, Suryapranata H, Luijten H E, Serruys P W
Catheterization Laboratory, Thoraxcenter, Rotterdam, The Netherlands.
Am Heart J. 1989 May;117(5):991-6. doi: 10.1016/0002-8703(89)90851-x.
The first 840 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) performed in the same institution were retrospectively assessed at an average follow-up period of 25 months after the initial procedure. The study population consisted of 506 patients with stable angina pectoris (group 1) and 334 patients with unstable angina pectoris (group 2). Clinical end points were death, nonfatal myocardial infarction, recurrent angina pectoris necessitating bypass surgery or repeat PTCA, and event-free survival. The two groups were comparable with respect to age, sex, previous myocardial infarction, ejection fraction, and number of diseased vessels. PTCA was successful in 83.0% of group 1 and 87.1% of group 2. Follow-up rates were expressed as events per attempted PTCA in a patient group. No difference in survival was observed between the two groups, the mortality rate being approximately 2.8% at 25 months. In the group with stable angina pectoris there was a lower incidence of nonfatal myocardial infarction within the first 24 hours after angioplasty; 4.3% vs 9.0% (p less than 0.01). During long-term follow-up the increase in the incidence of nonfatal myocardial infarction was similar, resulting in an overall long-term follow-up infarction rate of 8.3% and 14.2%, respectively (p less than 0.01). A higher event-free survival was observed in group 1 within 24 hours after PTCA: 93.7% vs 84.2% (p less than 0.01). During subsequent follow-up the difference in event-free survival between the two groups was no longer significant: 68.5% vs 61.2%.(ABSTRACT TRUNCATED AT 250 WORDS)
对在同一机构接受经皮腔内冠状动脉成形术(PTCA)的前840例连续患者进行回顾性评估,初始手术后平均随访25个月。研究人群包括506例稳定型心绞痛患者(第1组)和334例不稳定型心绞痛患者(第2组)。临床终点为死亡、非致命性心肌梗死、需要搭桥手术或重复PTCA的复发性心绞痛以及无事件生存。两组在年龄、性别、既往心肌梗死、射血分数和病变血管数量方面具有可比性。第1组PTCA成功率为83.0%,第2组为87.1%。随访率以患者组中每例尝试PTCA的事件数表示。两组生存率无差异,25个月时死亡率约为2.8%。在稳定型心绞痛组,血管成形术后最初24小时内非致命性心肌梗死发生率较低;分别为4.3%和9.0%(p<0.01)。在长期随访中,非致命性心肌梗死发生率的增加相似,总体长期随访梗死率分别为8.3%和14.2%(p<0.01)。PTCA后24小时内第1组无事件生存率较高:分别为93.7%和84.2%(p<0.01)。在随后的随访中,两组无事件生存率的差异不再显著:分别为68.5%和61.2%。(摘要截断于250字)