O'Donnell T F, Callow A D, Willet C, Payne D, Cleveland R J
Ann Surg. 1983 Dec;198(6):705-12. doi: 10.1097/00000658-198312000-00007.
In a series of 531 CENDX, preoperative cardiac risk was categorized by clinical criteria. Patients with CAD (history of previous MI, angina, congestive heart failure, and/or electrocardiographic evidence of CAD were selected for more invasive studies based on clinical criteria. The overall incidence of postoperative myocardial infarction was 2.5% and increased slightly to 4% in patients with symptomatic cardiac disease. More importantly, the overall mortality was 0.9% and only 3 of 13 (23%) postoperative myocardial infarctions were fatal. Neurologic complications averaged 1.4% and approximately 70% were related to preceding cardiac events. Twenty-two patients or 4% of the entire series underwent carotid endarterectomy combined with coronary artery bypass graft and this approach was associated with one death and one stroke. Therefore, we conclude that a selective approach to coronary arteriography and subsequent CABG based on clinical criteria is associated with an acceptably low mortality and cardiac morbidity.
在一系列531例CENDX中，术前心脏风险根据临床标准进行分类。患有CAD（既往心肌梗死、心绞痛、充血性心力衰竭病史和/或CAD的心电图证据）的患者根据临床标准被选入更具侵入性的研究。术后心肌梗死的总体发生率为2.5%，有症状性心脏病的患者略有增加至4%。更重要的是，总体死亡率为0.9%，13例术后心肌梗死中只有3例（23%）是致命的。神经系统并发症平均为1.4%，约70%与先前的心脏事件有关。22例患者（占整个系列的4%）接受了颈动脉内膜切除术联合冠状动脉旁路移植术，这种方法与1例死亡和1例中风相关。因此，我们得出结论，基于临床标准对冠状动脉造影和随后的冠状动脉旁路移植术采取选择性方法，其死亡率和心脏发病率低至可接受水平。
