心肌血运重建：对合作研究的反驳
Myocardial revascularization: a rebuttal of the cooperative study.
作者信息
Kaiser G C, Barner H B, Tyras D H, Codd J E, Mudd J G, Willman V L
出版信息
Ann Surg. 1978 Sep;188(3):331-40. doi: 10.1097/00000658-197809000-00008.
From January 1972 through December 1974, at Saint Louis University Medical Center (SLU), 345 patients similar to those of the VA Cooperative Coronary Artery Study received CABG. Operative mortality was SLU 2.3%, VA 5.6% (p < 0.05). Perioperative myocardial infarction rate was SLU 8.4%, VA 18% (p < 0.005). One year graft patency was SLU 87%, VA 71%; all grafts patent SLU 76%, VA 54%; at least one graft patent SLU 96%, VA 89%. SLU angina pectoris relief at five years was 90%. SLU patients free of myocardial infarction five years postoperatively was 83%. Comparative cumulative four year survivals were: [Table: see text] Cumulative four-year survival in 272 SLU patients (79%) completely revascularized was 94%, compared to SLU entire group of 95%, VA medical 86% (p < 0.002) and VA surgical 85% (p < 0.002). Comparing 1972-74 SLU results to VA medical and surgical groups, CABG prolonged life in patients with double and triple vessel disease and in those completely revascularized.
1972年1月至1974年12月期间，在圣路易斯大学医学中心（SLU），345名与退伍军人事务部（VA）合作冠状动脉研究中的患者接受了冠状动脉搭桥术（CABG）。SLU的手术死亡率为2.3%，VA为5.6%（p<0.05）。围手术期心肌梗死发生率SLU为8.4%，VA为18%（p<0.005）。一年时移植血管通畅率SLU为87%，VA为71%；所有移植血管通畅率SLU为76%，VA为54%；至少有一根移植血管通畅率SLU为96%，VA为89%。SLU五年时心绞痛缓解率为90%。SLU术后五年无心肌梗死的患者为83%。比较累积四年生存率如下：[表格：见原文]272名（79%）完全血运重建的SLU患者的累积四年生存率为94%，相比之下，SLU整个组为95%，VA内科组为86%（p<0.002），VA外科组为85%（p<0.002）。将1972 - 1974年SLU的结果与VA内科和外科组进行比较，冠状动脉搭桥术延长了双支和三支血管病变患者以及完全血运重建患者的寿命。
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