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变异型心绞痛患者的长期预后及影响因素

Long-term prognosis for patients with variant angina and influential factors.

作者信息

Yasue H, Takizawa A, Nagao M, Nishida S, Horie M, Kubota J, Omote S, Takaoka K, Okumura K

机构信息

Division of Cardiology, Kumamoto University Medical School, Japan.

出版信息

Circulation. 1988 Jul;78(1):1-9. doi: 10.1161/01.cir.78.1.1.

Abstract

Two hundred forty-five patients with variant angina were followed for an average of 80.5 months (range, 36-184 months). Survival rate at 1, 3, 5, and 10 years was 98%, 97%, 97%, and 93%, respectively. Survival rate without myocardial infarction at 1, 3, 5, and 10 years was 86%, 85%, 83%, and 81%, respectively. By univarite analysis, ST segment elevation in both the anterior and inferior electrocardiographic leads was the most important factor influencing survival, followed by use of calcium antagonists, left ventricular function, smoking, and alcohol intake. The variables that significantly correlated with survival without myocardial infarction were use of calcium antagonists, left ventricular function, extent and severity of coronary artery disease, coronary artery bypass surgery, and disease activity. Multivariate analysis using the Cox proportional hazards model showed that intake of calcium antagonists, extent and severity of coronary artery disease, and ST segment elevation in both the anterior and inferior leads were significant independent predictors of survival without myocardial infarction. We conclude that long-term prognosis for patients with variant angina is relatively good and that use of calcium antagonists improves it.

摘要

245例变异型心绞痛患者接受了平均80.5个月(范围36 - 184个月)的随访。1年、3年、5年和10年的生存率分别为98%、97%、97%和93%。1年、3年、5年和10年无心肌梗死的生存率分别为86%、85%、83%和81%。单因素分析显示,心电图前壁和下壁导联ST段抬高是影响生存的最重要因素,其次是钙拮抗剂的使用、左心室功能、吸烟和饮酒。与无心肌梗死生存显著相关的变量有钙拮抗剂的使用、左心室功能、冠状动脉疾病的范围和严重程度、冠状动脉搭桥手术以及疾病活动度。使用Cox比例风险模型进行多因素分析显示,钙拮抗剂的使用、冠状动脉疾病的范围和严重程度以及前壁和下壁导联ST段抬高是无心肌梗死生存的显著独立预测因素。我们得出结论,变异型心绞痛患者的长期预后相对良好,且钙拮抗剂的使用可改善预后。

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