Hollander G, Ozick H, Greengart A, Shani J, Lichstein E
Am Heart J. 1984 Dec;108(6):1412-6. doi: 10.1016/0002-8703(84)90685-9.
Thirty-eight patients with first nontransmural myocardial infarction were studied to determine prognosis and clinical markers of a high-risk subgroup. We found a high incidence of reinfarction (18%) at a median time of 16 days post nontransmural infarction (seven patients). Reinfarction was uniformly associated with death within 24 hours. A total of 14 patients (37%) either died (eight patients) or required urgent revascularization (six patients). Predominant ST segment depression with presenting nontransmural infarction and a history of prior angina were associated with increased mortality (p less than 0.05 and p = 0.05, respectively). We conclude that patients with nontransmural infarction are at high risk for early recurrent infarction. Patients with history of prior angina and predominant ST segment depression may be at particularly high risk. Reinfarction in these patients is frequently extensive. We recommend that these patients be considered for early coronary angiography.
对38例首次发生非透壁性心肌梗死的患者进行了研究，以确定高危亚组的预后和临床标志物。我们发现在非透壁性梗死中位时间16天时再梗死发生率较高（18%，7例患者）。再梗死均与24小时内死亡相关。共有14例患者（37%）死亡（8例患者）或需要紧急血运重建（6例患者）。出现非透壁性梗死时主要表现为ST段压低以及既往有劳力性心绞痛病史与死亡率增加相关（分别为p<0.05和p=0.05）。我们得出结论，非透壁性梗死患者早期复发梗死的风险较高。有既往劳力性心绞痛病史且主要表现为ST段压低的患者可能风险尤其高。这些患者的再梗死往往范围广泛。我们建议考虑对这些患者进行早期冠状动脉造影。
