Kasahara S, Shibata N, Miyazaki Y, Mizobe H, Shoda M, Ueda T, Nakano J, Miura M, Miyazawa Y, Komatsu Y
Kokyu To Junkan. 1989 Oct;37(10):1089-95.
We surveyed the clinical characteristics, treatment, and prognosis of 162 patients with unstable angina, who were admitted to our center between 1985 and 1987. There were 112 males and 50 females, with a mean age of 65 years. The clinical characteristics according to the American Heart Association classification were new angina of effort in 21%, changing pattern in 61%, and new angina at rest in 18% of the patients. ECG recordings during attacks of angina were obtained in 70%, and ST elevation was detected in 11%, ST depression in 54%, and T wave abnormality in 5%. Coronary arteriography performed in 42% of the patients revealed single vessel lesion in 21%, two vessel lesion in 10%, three vessel lesion in 5%, and left main trunk lesion in 3% of the patients. Seventy-seven percent of the patients were controlled by medical therapy, including nitrates, calcium antagonists, and, in some cases, beta blockades. Three percent of the patients were controlled with intra aortic balloon pumping in addition to medical therapy. Coronary artery bypass graft surgery (CABG) was performed in 6% of the patients. Since 1987, percutaneous transluminal angioplasty (PTCA) was introduced in our center and PTCA was performed in 9 patients (6%). Restenosis of the dilated portions of the coronary artery was observed and PTCA was again performed in 2 of 9 patients (22%). All patients who received CABG or PTCA survived and have been free from angina or myocardial infarction. Non-fatal myocardial infarction occurred in 10 cases (5.6%) and fatal infarction occurred in one patient (0.6%).
我们调查了1985年至1987年间收治于本中心的162例不稳定型心绞痛患者的临床特征、治疗及预后情况。其中男性112例,女性50例,平均年龄65岁。根据美国心脏协会的分类,临床特征如下:劳力性新发心绞痛患者占21%,心绞痛发作形式改变患者占61%,静息性新发心绞痛患者占18%。70%的患者在心绞痛发作时进行了心电图记录,其中11%检测到ST段抬高,54%检测到ST段压低,5%检测到T波异常。42%的患者进行了冠状动脉造影,结果显示单支血管病变患者占21%,双支血管病变患者占10%,三支血管病变患者占5%,左主干病变患者占3%。77%的患者通过药物治疗得到控制,所用药物包括硝酸盐类、钙拮抗剂,部分患者还使用了β受体阻滞剂。3%的患者在药物治疗基础上联合主动脉内球囊反搏治疗得到控制。6%的患者接受了冠状动脉旁路移植术(CABG)。自1987年起,我们中心引入了经皮腔内血管成形术(PTCA),9例患者(6%)接受了该治疗。观察到9例患者中有2例(22%)冠状动脉扩张部位出现再狭窄,并再次进行了PTCA。所有接受CABG或PTCA治疗的患者均存活,且未再发生心绞痛或心肌梗死。非致命性心肌梗死发生10例(5.6%),致命性心肌梗死发生1例(0.6%)。