Moise A, Clement B, Saltiel J
Department of Radiology, Montreal Heart Institute, Quebec, Canada.
Am J Cardiol. 1988 Jun 1;61(15):1255-9. doi: 10.1016/0002-9149(88)91165-4.
The clinical and angiographic correlates and the prognostic significance of the "coronary extent score" in a consecutive series of 313 patients who were catheterized twice were studied. The extent score was defined as the number of 5 to 75% stenosed segments in a 15-segment coding system. The extent score was higher in subgroups of patients with new onset angina at the time of the first angiogram (4.3 +/- 2.4 vs 3.3 +/- 1.9, p less than 0.01), unstable angina at the time of the second angiogram (4.0 +/- 2.0 vs 3.3 +/- 1.9, p less than 0.05) or multifocal progression from the first to the second angiogram (4.0 +/- 2.1 vs 3.3 +/- 1.9, p less than 0.01), suggesting that it is an index of active coronary artery disease. The extent score did not correlate with the number of diseased vessels (r = 0.03), the ejection fraction (r = 0.03), the Friesinger score (r = 0.04) and the Gensini score (r = -0.07) (difference not significant for each). Cox's model was fit to the survival data recorded on a prospective basis after the second angiogram. Independent predictors of survival were ejection fraction (p less than 0.001), extent score (p = 0.001), number of diseased vessels (p = 0.01) and percent of left main luminal stenosis (p less than 0.05). The extent score was also an independent predictor of myocardial infarction and unstable angina. Thus, the extent score, an index of active progressive disease, is an independent predictor of mortality and cardiac events in patients with coronary artery disease.
对连续313例接受了两次心导管检查的患者，研究了“冠状动脉范围评分”的临床及血管造影相关性及其预后意义。范围评分定义为在一个15节段编码系统中5%至75%狭窄节段的数量。在首次血管造影时新发心绞痛的患者亚组中范围评分更高（4.3±2.4对3.3±1.9，p<0.01），在第二次血管造影时不稳定心绞痛的患者亚组中（4.0±2.0对3.3±1.9，p<0.05），或从首次到第二次血管造影出现多灶进展的患者亚组中（4.0±2.1对3.3±1.9，p<0.01），提示它是活动性冠状动脉疾病的一个指标。范围评分与病变血管数量（r=0.03）、射血分数（r=0.03）、弗里辛格评分（r=0.04）和詹西尼评分（r=-0.07）均无相关性（各差异均无统计学意义）。Cox模型用于拟合第二次血管造影后前瞻性记录的生存数据。生存的独立预测因素为射血分数（p<0.001）、范围评分（p=0.001）、病变血管数量（p=0.01）和左主干管腔狭窄百分比（p<0.05）。范围评分也是心肌梗死和不稳定心绞痛的独立预测因素。因此，范围评分作为活动性进展性疾病的一个指标，是冠状动脉疾病患者死亡率和心脏事件的独立预测因素。
