Talley J D, Hurst J W, King S B, Douglas J S, Roubin G S, Gruentzig A R, Anderson H V, Weintraub W S
Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Emory University Hospital, Atlanta, GA 30322.
Circulation. 1988 Apr;77(4):820-9. doi: 10.1161/01.cir.77.4.820.
This study was performed to define the 5 year clinical status of 427 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in 1981. Their mean age was 54 +/- 10 years (+/- 1 SD). Sixty-one percent had unstable angina, 23% had prior myocardial infarction, 86% had one-vessel disease, and 92% had normal left ventricular function. Sixty-seven percent of patients had left anterior descending artery stenosis. Angiographic success was achieved in 84% of patients. Coronary bypass surgery was required in 9.6% of patients, in 5.9% as an emergency procedure. There were no in-hospital deaths. Follow-up at 5 years was 100% complete. There were 15 late deaths (96.3 +/- 1.0% survival), including seven of cardiac cause (98.1 +/- 0.7% cardiac survival). Myocardial infarction occurred in 24 patients (94% freedom from myocardial infarction), coronary bypass surgery was required in 63 (84% freedom from bypass surgery), and 365 patients (85%) were asymptomatic at follow-up. At 5 years, 83 patients (20%) had required an additional PTCA. Unstable angina pectoris and proximal left anterior descending coronary artery stenoses were present in 162 patients. The overall survival and cardiac survival in this subset was 94.4 +/- 1.8% and 98.1 +/- 1.1%, respectively. The excellent survival and low event rates over 5 years in this population support the concept that PTCA is safe and effective for patients with symptomatic angina pectoris, single-vessel disease, and normal left ventricular function.
本研究旨在明确1981年接受经皮腔内冠状动脉成形术（PTCA）的427例患者的5年临床状况。他们的平均年龄为54±10岁（±1标准差）。61%的患者患有不稳定型心绞痛，23%的患者既往有心肌梗死，86%的患者有单支血管病变，92%的患者左心室功能正常。67%的患者有左前降支动脉狭窄。84%的患者血管造影成功。9.6%的患者需要进行冠状动脉搭桥手术，其中5.9%为急诊手术。住院期间无死亡病例。5年随访率为100%。有15例晚期死亡（生存率为96.3±1.0%），其中7例死于心脏原因（心脏生存率为98.1±0.7%）。24例患者发生心肌梗死（无心肌梗死发生率为94%），63例患者需要进行冠状动脉搭桥手术（无搭桥手术发生率为84%），365例患者（85%）在随访时无症状。5年时，83例患者（20%）需要再次进行PTCA。162例患者存在不稳定型心绞痛和左前降支冠状动脉近端狭窄。该亚组的总体生存率和心脏生存率分别为94.4±1.8%和98.1±1.1%。该人群5年的高生存率和低事件发生率支持了PTCA对有症状心绞痛、单支血管病变和左心室功能正常的患者安全有效的观点。
