Califf R M, Phillips H R, Hindman M C, Mark D B, Lee K L, Behar V S, Johnson R A, Pryor D B, Rosati R A, Wagner G S
J Am Coll Cardiol. 1985 May;5(5):1055-63. doi: 10.1016/s0735-1097(85)80005-x.
The prognostic value of a coronary artery jeopardy score was evaluated in 462 consecutive nonsurgically treated patients with significant coronary artery disease, but without significant left main coronary stenosis. The jeopardy score is a simple method for estimating the amount of myocardium at risk on the basis of the particular location of coronary artery stenoses. In patients with a previous myocardial infarction, higher jeopardy scores were associated with a lower left ventricular ejection fraction. When the jeopardy score and the number of diseased vessels were considered individually, each descriptor effectively stratified prognosis. Five year survival was 97% in patients with a jeopardy score of 2 and 95, 85, 78, 75 and 56%, respectively, for patients with a jeopardy score of 4, 6, 8, 10 and 12. In multivariable analysis when only jeopardy score and number of diseased vessels were considered, the jeopardy score contained all of the prognostic information. Thus, the number of diseased vessels added no prognostic information to the jeopardy score. The left ventricular ejection fraction was more closely related to prognosis than was the jeopardy score. When other anatomic factors were examined, the degree of stenosis of each vessel, particularly the left anterior descending coronary artery, was found to add prognostic information to the jeopardy score. Thus, the jeopardy score is a simple method for describing the coronary anatomy. It provides more prognostic information than the number of diseased coronary arteries, but it can be improved by including the degree of stenosis of each vessel and giving additional weight to disease of the left anterior descending coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)
在462例连续接受非手术治疗的严重冠状动脉疾病患者中评估了冠状动脉危险评分的预后价值,这些患者无严重左主干冠状动脉狭窄。危险评分是一种基于冠状动脉狭窄的特定位置来估计有风险心肌量的简单方法。在既往有心肌梗死的患者中,较高的危险评分与较低的左心室射血分数相关。当单独考虑危险评分和病变血管数量时,每个指标都能有效分层预后。危险评分为2的患者5年生存率为97%,危险评分为4、6、8、10和12的患者5年生存率分别为95%、85%、78%、75%和56%。在多变量分析中,当仅考虑危险评分和病变血管数量时,危险评分包含了所有预后信息。因此,病变血管数量并未给危险评分增加预后信息。左心室射血分数与预后的关系比危险评分更密切。当检查其他解剖因素时,发现每条血管的狭窄程度,尤其是左前降支冠状动脉的狭窄程度,能给危险评分增加预后信息。因此,危险评分是一种描述冠状动脉解剖结构的简单方法。它比病变冠状动脉数量提供更多的预后信息,但通过纳入每条血管的狭窄程度并给予左前降支冠状动脉疾病额外权重可对其进行改进。(摘要截短于250字)