Eugene J, Ott R A, Piters K M, Stemmer E A
Arch Surg. 1985 Mar;120(3):279-82. doi: 10.1001/archsurg.1985.01390270019004.
We performed a prospective study in 207 patients with unstable angina pectoris (UA) to identify factors associated with operative mortality (OM) and perioperative myocardial infarction (MI) from myocardial revascularization. The OM was 3.9% (8/207) and the incidence of MI was 11% (23/207). Clinical variables (age, prior MI, electrocardiographic evidence, symptoms, left ventricular function) and operative variables (incomplete revascularization, cardiopulmonary bypass time, cross-clamp time) did not correlate with OM or MI. Operative mortality was associated with critical triple-vessel disease, but not left main coronary artery disease, and accounted for seven of the eight deaths (P less than .01). Myocardial infarction was associated with elective surgery (22/167) as opposed to urgent surgery (1/40) (P less than .01). Therefore, patients with critical triple-vessel disease are the highest risk group for OM, and urgent operation seems to reduce the incidence of MI in patients with UA.
我们对207例不稳定型心绞痛（UA）患者进行了一项前瞻性研究，以确定与心肌血运重建术的手术死亡率（OM）和围手术期心肌梗死（MI）相关的因素。手术死亡率为3.9%（8/207），心肌梗死发生率为11%（23/207）。临床变量（年龄、既往心肌梗死、心电图证据、症状、左心室功能）和手术变量（血运重建不完全、体外循环时间、阻断时间）与手术死亡率或心肌梗死均无相关性。手术死亡率与严重三支血管病变相关，但与左主干冠状动脉疾病无关，8例死亡中有7例与之相关（P<0.01）。心肌梗死与择期手术（22/167）相关，而非急诊手术（1/40）（P<0.01）。因此，严重三支血管病变患者是手术死亡率最高的风险组，急诊手术似乎可降低UA患者的心肌梗死发生率。
