Thijs Plokker H W, Ernst S M, Bal E T, van den Berg E C, Mast G E, van der Feltz T A, Ascoop C A
St. Antonius Hospital, Department of Cardiology, Nieuwegein, The Netherlands.
Cathet Cardiovasc Diagn. 1988;14(1):15-8. doi: 10.1002/ccd.1810140104.
The purpose of this study was to assess the results of percutaneous transluminal coronary angioplasty (PTCA) in 469 consecutive patients with unstable angina pectoris refractory to medical therapy. The primary success rate was 88%, but, since the introduction of the steerable wire system, the success rate has increased to 90%. Mortality was 1%. There were no statistically significant differences in success rates per vessel. Actuarial total 5 year survival was 94%. After 5 years, actuarially, 79% of the patients were free of events (recurrence of angina, residual myocardial infarction, re-PTCA, coronary artery bypass surgery or death). Aortocoronary bypass surgery was performed in 9% of the 469 patients. The angiographic recurrence rate was 28%, but, of the patients who were symptom-free and who had a follow-up angiogram, only 3% had an angiographic recurrence, whereas 98% of the patients who did not have a repeat angiogram were symptom-free. It is concluded that, in a selected group of patients with the clinical syndrome of unstable angina pectoris refractory to medical therapy, the long-term clinical results are good and survival is excellent.
本研究的目的是评估469例经药物治疗无效的不稳定型心绞痛患者经皮腔内冠状动脉成形术（PTCA）的结果。主要成功率为88%，但自引入可控导丝系统以来，成功率已提高到90%。死亡率为1%。各血管的成功率无统计学显著差异。5年总生存精算率为94%。5年后，精算显示，79%的患者无事件发生（心绞痛复发、残余心肌梗死、再次PTCA、冠状动脉搭桥手术或死亡）。469例患者中有9%接受了主动脉冠状动脉搭桥手术。血管造影复发率为28%，但在无症状且接受随访血管造影的患者中，只有3%有血管造影复发，而未进行重复血管造影的患者中有98%无症状。结论是，在一组经药物治疗无效的不稳定型心绞痛临床综合征患者中，长期临床结果良好，生存率很高。
