Danchin N, Brengard A, Ethevenot G, Briançon S, Cuillière M, Aliot E, Pernot C, Gilgenkrantz J M, Mathieu P, Cherrier F
Department of Cardiology and Cardiovascular Surgery, University Hospital of Nancy-Brabois, France.
Br Heart J. 1988 Mar;59(3):275-9. doi: 10.1136/hrt.59.3.275.
The 10 year outcome of patients with single vessel coronary artery disease who underwent coronary angiography more than 10 years before and who would have been potential candidates for percutaneous transluminal coronary angioplasty had it been available then is reported. Long term follow up data were obtained in 96 (91 men, five women; mean age 48 years) of 105 consecutive patients with single vessel coronary artery disease (greater than 70% stenosis), judged suitable for coronary angioplasty. Fifty patients had coronary bypass surgery within six months of catheterisation (surgical group) and 46 were treated medically (medical group). At entry to the study more patients in the surgical group had unstable angina, but fewer had a previous history of myocardial infarction. Ten year survival was 91% and remained excellent in all the subsets analysed. Moreover, the quality of life of these patients was good. Over the 10 year follow up, 16 (36%) of the patients treated medically and 13 (26%) in the surgical group were admitted to hospital because of cardiovascular events (including late coronary surgery in four of the patients treated medically). Lastly, 54/69 (78%) of the patients who were employed before catheterisation resumed work and 29 (42%) were still employed 10 years later. Although these data must be interpreted with care because of the limitations inherent in all retrospective studies, it appears that the long term results of conventional medical or surgical treatment are excellent in patients with single vessel coronary artery disease in whom percutaneous transluminal coronary angioplasty is now an option.
报告了10多年前接受冠状动脉造影的单支冠状动脉疾病患者的10年预后情况,若当时有经皮冠状动脉腔内血管成形术,这些患者本可成为该手术的潜在候选对象。在105例连续的单支冠状动脉疾病(狭窄程度大于70%)且被判定适合冠状动脉血管成形术的患者中,96例(91例男性,5例女性;平均年龄48岁)获得了长期随访数据。50例患者在导管插入术后6个月内接受了冠状动脉搭桥手术(手术组),46例接受药物治疗(药物组)。在研究开始时,手术组中不稳定型心绞痛患者更多,但有心肌梗死病史的患者更少。10年生存率为91%,在所有分析的亚组中仍然很高。此外,这些患者的生活质量良好。在10年的随访中,药物治疗组有16例(36%)患者因心血管事件入院,手术组有13例(26%)患者因心血管事件入院(包括药物治疗组中的4例患者进行了晚期冠状动脉手术)。最后,69例在导管插入术前就业的患者中有54例(78%)恢复了工作,10年后仍有29例(42%)在就业。尽管由于所有回顾性研究固有的局限性,这些数据必须谨慎解读,但对于现在可选择经皮冠状动脉腔内血管成形术的单支冠状动脉疾病患者,传统药物或手术治疗的长期效果似乎很好。