Simmons B E, Castaner A, Campo A, Ferlinz J, Mar M, Cooper R
Division of Adult Cardiology, Cook County Hospital, Chicago, IL 60612.
Am Heart J. 1988 Jul;116(1 Pt 1):90-7. doi: 10.1016/0002-8703(88)90254-2.
During a 4-year period, 1,022 blacks underwent angiography at our institution for the presumptive diagnosis of coronary artery disease (CAD). Among the 454 men, at least one coronary stenosis was demonstrated in 288 cases (63%), while significant narrowing was found in 242 of 568 women (43%). Despite the frequent finding of normal coronary arteries, those patients with significant CAD had severe disease. Thus among men with CAD, left main stenosis was present in 7% and three-vessel narrowing was seen in 53%; among the women, 8% had left main stenosis and three-vessel disease was present in 52%. Two countervailing processes appear to be occurring, namely (1) identification of true coronary symptoms is difficult in this group of patients and (2) diagnosis of true cases occurs late in the course of the disease and the distribution of the number of vessels involved is skewed upwards. Increased echocardiographically determined left ventricular mass and hypertension were prevalent among all groups. These data suggest that the approach to the diagnosis of CAD in the black population is difficult and severe CAD occurs frequently.
在4年期间，1022名黑人在我们机构接受了血管造影检查，以对冠状动脉疾病（CAD）进行初步诊断。在454名男性中，288例（63%）显示至少有一处冠状动脉狭窄，而在568名女性中，242例（43%）发现有明显狭窄。尽管经常发现冠状动脉正常，但那些患有严重CAD的患者病情严重。因此，在患有CAD的男性中，7%存在左主干狭窄，53%可见三支血管狭窄；在女性中，8%有左主干狭窄，52%存在三支血管病变。似乎有两个相互抵消的过程在发生，即（1）在这组患者中难以识别真正的冠状动脉症状，（2）真正病例的诊断在疾病过程中较晚出现，且受累血管数量的分布向上倾斜。超声心动图测定的左心室质量增加和高血压在所有组中都很普遍。这些数据表明，黑人人群中CAD的诊断方法存在困难，且严重CAD经常发生。
