Cooper R, Castaner A, Campo A, Islam N, Simmons B
Division of Cardiology, Cook County Hospital, Chicago, Illinois 60612-9985.
Am J Cardiol. 1989 Apr 1;63(12):788-91. doi: 10.1016/0002-9149(89)90043-x.
A growing body of evidence suggests that survival after acute myocardial infarction (AMI) is considerably worse among blacks than whites. The severity of coronary artery disease (CAD), as measured by the number of diseased vessels and the degree of left ventricular dysfunction, is the major determinant of survival after AMI. To determine whether or not the severity of CAD could explain the poor prognosis in a cohort of blacks followed at this institution, cardiac catheterization was performed in a consecutive series of 51 patients less than 70 years of age. All patients were studied within 2 weeks after AMI. The mean age of the patients was 56 +/- 8 (mean +/- standard deviation) and 71% were men. A greater than or equal to 50 narrowing in 0, 1, 2 or 3 coronary arteries was noted in 5, 24, 40 and 31%, respectively. Left main stenosis was present in 3 patients (6%) and the mean left ventricular ejection fraction was 55%. In a subgroup of 20 patients echocardiographic estimates of left ventricular mass/height yielded a mean of 196 g/m, and left ventricular hypertrophy on echocardiogram was present in 74%. These data indicate that among blacks with AMI in this series CAD was only modestly more severe than expected and suggest that other factors most likely explain the high mortality in blacks after hospital discharge.
越来越多的证据表明，急性心肌梗死（AMI）后黑人的生存率远低于白人。通过病变血管数量和左心室功能障碍程度衡量的冠状动脉疾病（CAD）严重程度，是AMI后生存的主要决定因素。为了确定CAD的严重程度是否可以解释在本机构随访的一组黑人患者的不良预后，对连续51例年龄小于70岁的患者进行了心脏导管检查。所有患者均在AMI后2周内接受研究。患者的平均年龄为56±8（平均±标准差），71%为男性。分别有5%、24%、40%和31%的患者在0、1、2或3支冠状动脉中出现大于或等于50%的狭窄。3例患者（6%）存在左主干狭窄，平均左心室射血分数为55%。在20例患者的亚组中，超声心动图对左心室质量/身高的估计平均值为196 g/m，74%的患者超声心动图显示有左心室肥厚。这些数据表明，在该系列AMI黑人患者中，CAD仅比预期稍严重，提示其他因素很可能解释了黑人出院后的高死亡率。
