Lee G, Low R I, Takeda P, Joe P, DeMaria A N, Amsterdam E A, Lui H, Dietrich P, Lee K, Mason D T
Am Heart J. 1982 Oct;104(4 Pt 2):921-4. doi: 10.1016/0002-8703(82)90265-4.
Thirty-four patients with acute myocardial infarction (mean age 55 years) who received intracoronary streptokinase for coronary thrombosis were followed for a mean of 9.4 months (longest 25 months) following the procedure of percutaneous transluminal coronary recanalization (PTCR). Twelve patients had undergone coronary artery bypass graft surgery (CABG), one had percutaneous transluminal coronary angioplasty (PTCA), and 21 received medical therapy. Among patients having CABG and PTCA, nearly 70% no longer had chest pain or reinfarction, and 62% were in New York functional class I status; there were no deaths, and there was only one reinfarction, in a patient who had graft closure. In contrast, 43% of medically treated patients had chest pain or reinfarction or had died on follow-up; only 32% of survivors were in class I functional status. Further, 71% of medically treated patients who were receiving warfarin had no chest pain and on reinfarction, whereas the majority (56%) of patients who did not receive either warfarin or antiplatelet agents either had chest pain or reinfarction or died. The importance of CABG/PTCA and anticoagulant therapy is stressed to prevent recurrent ischemia, reinfarction, and reocclusion following successful reperfusion by means of PTCR in acute myocardial infarction.
34例急性心肌梗死患者（平均年龄55岁）因冠状动脉血栓形成接受冠状动脉内链激酶治疗，在经皮腔内冠状动脉再通术（PTCR）后平均随访9.4个月（最长25个月）。12例患者接受了冠状动脉旁路移植术（CABG），1例接受了经皮腔内冠状动脉成形术（PTCA），21例接受了药物治疗。在接受CABG和PTCA的患者中，近70%不再有胸痛或再梗死，62%处于纽约心功能I级状态；无死亡病例，仅1例再梗死，该患者移植血管闭塞。相比之下，43%接受药物治疗的患者在随访时有胸痛、再梗死或死亡；仅32%的幸存者处于I级功能状态。此外，接受华法林治疗的药物治疗患者中，71%无胸痛且无再梗死，而未接受华法林或抗血小板药物治疗的患者中，大多数（56%）有胸痛、再梗死或死亡。强调CABG/PTCA和抗凝治疗对于预防急性心肌梗死患者经PTCR成功再灌注后复发性缺血、再梗死和再闭塞的重要性。
