Moise A, Lespérance J, Théroux P, Taeymans Y, Goulet C, Bourassa M G
Am J Cardiol. 1984 Dec 1;54(10):1176-81. doi: 10.1016/s0002-9149(84)80063-6.
A new coronary artery occlusion was found in 98 of 313 consecutive patients (31%) with coronary artery disease treated medically who underwent catheterization twice, 39 +/- 25 months apart. Multivariate logistic regression displayed 8 independent predictors of new occlusion. Four were available at the time of the second angiogram: the interval between the 2 studies (p = 0.005), a decrease in ejection fraction (p less than 0.01), the appearance of bundle branch block (p less than 0.01), and an interim myocardial infarction (p less than 0.05). Four other predictors were found at the time of the first angiogram: 2 angiographic characteristics, 1 related to the severity (presence of an 80% or greater luminal diameter narrowing of an artery supplying a non-akinetic left ventricular segment [p less than 0.005]) and 1 to the extent (count of the lesions narrowed 75% or less in luminal diameter in a 15-segment coding system [p less than 0.05]) of coronary artery disease, and 2 risk factors: smoking status (p less than 0.05) and male sex (p less than 0.05). The 140 male smokers with at least 80% diameter stenosis or at least 4 segments with moderate (75% or less) stenosis were at a higher risk of occlusion than the 173 other patients after intervals of less than 2 years (13 of 53 vs 7 of 74, p less than 0.01), 2 to 4 years (23 of 40 vs 10 of 47, p less than 0.005) and more than 4 years (27 of 47 vs 18 of 54, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
在接受药物治疗的313例冠心病患者中，98例（31%）连续两次接受导管插入术，两次间隔39±25个月，发现有新的冠状动脉闭塞。多因素逻辑回归显示有8个新闭塞的独立预测因素。在第二次血管造影时可获得4个因素：两次研究之间的间隔时间（p = 0.005）、射血分数降低（p<0.01）、束支传导阻滞的出现（p<0.01）和期间发生的心肌梗死（p<0.05）。在第一次血管造影时发现另外4个预测因素：2个血管造影特征，1个与严重程度相关（供应无运动的左心室节段的动脉管腔直径狭窄80%或更严重[p<0.005]），1个与范围相关（在15节段编码系统中管腔直径狭窄75%或更低的病变数量[p<0.05]）以及2个危险因素：吸烟状况（p<0.05）和男性（p<0.05）。140例男性吸烟者，管腔直径狭窄至少80%或至少4节段有中度（75%或更低）狭窄，在间隔时间少于2年（53例中的13例 vs 74例中的7例，p<0.01）、2至4年（40例中的23例 vs 47例中的10例，p<0.005）和超过4年（47例中的27例 vs 54例中的18例，p<0.05）时，比另外173例患者有更高的闭塞风险。（摘要截短于250字）
