Sterling R P, Graeber G M, Albus R A, Burton N A, Lough F C, Fleming A W
Am Heart J. 1984 Sep;108(3 Pt 2):695-9. doi: 10.1016/0002-8703(84)90657-4.
The impact of black-white differences in the prevalence of risk factors for coronary heart disease on the outcome of coronary bypass surgery has not been well defined. Preoperative status, coronary anatomy, and surgical results were reviewed in 54 black males operated on between December 1970 and August 1983. With the use of criteria established by the New York Heart Association, five patients were classified in class II, 34 were in class III, and 15 were in class IV. Five patients had unstable angina. The most common risk factor, cigarette smoking, occurred in 43 patients (80%). Thirty patients (56%) had hypertension, 10 (19%) were diabetic, 14 (26%) were obese, and 23 (43%) had a family history of coronary disease. Elevated cholesterol and triglyceride levels were present in 8 and 12 patients, respectively. An average of 2.9 grafts per patient was placed. Overall operative mortality was 5.6%. Prior to the use of cardioplegia in 1978, there were two deaths among 14 patients (mortality, 14%). Since 1978 there has been one death among 40 patients (mortality, 2.5%). Although immediate operative mortality appears not to be affected by black-white status, long-term prognosis may be influenced significantly by the high prevalence of hypertension and diabetes and the lower prevalence of hyperlipidemia among black patients.
冠心病危险因素患病率的黑白差异对冠状动脉搭桥手术结果的影响尚未明确界定。对1970年12月至1983年8月期间接受手术的54名黑人男性的术前状况、冠状动脉解剖结构和手术结果进行了回顾。根据纽约心脏协会制定的标准，5名患者被归类为II级，34名患者为III级，15名患者为IV级。5名患者患有不稳定型心绞痛。最常见的危险因素是吸烟，43名患者（80%）有此情况。30名患者（56%）患有高血压，10名（19%）患有糖尿病，14名（26%）肥胖，23名（43%）有冠心病家族史。分别有8名和12名患者胆固醇和甘油三酯水平升高。每位患者平均植入2.9根移植物。总体手术死亡率为5.6%。在1978年使用心脏停搏液之前，14名患者中有2例死亡（死亡率为14%）。自1978年以来，40名患者中有1例死亡（死亡率为2.5%）。虽然即刻手术死亡率似乎不受黑白种族状况的影响，但黑人患者中高血压和糖尿病的高患病率以及高脂血症的低患病率可能会对长期预后产生显著影响。
