Weiner D A, Ryan T J, McCabe C H, Chaitman B R, Sheffield L T, Ferguson J C, Fisher L D, Tristani F
J Am Coll Cardiol. 1984 Mar;3(3):772-9. doi: 10.1016/s0735-1097(84)80254-5.
To identify predictors of mortality in medically treated patients with symptomatic coronary artery disease, 30 variables were analyzed in 4,083 patients. Regression analysis demonstrated that seven variables were independent predictors of survival. A high risk subgroup (annual mortality rate above 5%) was identified, consisting of patients with either a congestive heart failure score of 3 to 4 or 1 mm or greater ST segment depression and final exercise stage of 1 or less. When all 30 variables were analyzed conjointly, the left ventricular contraction pattern (p less than 0.0001) and the number of diseased coronary vessels (p less than 0.003) proved to be the most important predictors of survival. In a subgroup of 572 patients with three vessel coronary disease and preserved left ventricular function, the probability of survival at 4 years ranged from 53% for patients only able to achieve stage 1/2 of exercise to 100% for patients able to exercise into stage 5 (p less than 0.004). Thus, in patients with defined coronary pathoanatomy, clinical and exercise variables primarily relating to the functional state of the left ventricle are helpful in assessing prognosis.
为了确定接受药物治疗的有症状冠状动脉疾病患者的死亡预测因素，对4083例患者的30个变量进行了分析。回归分析表明，7个变量是生存的独立预测因素。确定了一个高风险亚组（年死亡率高于5%），该亚组由充血性心力衰竭评分为3至4分或ST段压低1毫米或更大且最终运动阶段为1级或更低的患者组成。当对所有30个变量进行联合分析时，左心室收缩模式（p<0.0001）和病变冠状动脉血管数量（p<0.003）被证明是生存的最重要预测因素。在572例三支冠状动脉疾病且左心室功能保留的患者亚组中，4年生存率从仅能达到运动1/2阶段的患者的53%到能够运动到5阶段的患者的100%不等（p<0.004）。因此，在具有明确冠状动脉病理解剖结构的患者中，主要与左心室功能状态相关的临床和运动变量有助于评估预后。
