Califf R M, Conley M J, Behar V S, Harrell F E, Lee K L, Pryor D B, McKinnis R A, Rosati R A
Am J Cardiol. 1984 Jun 1;53(11):1489-95. doi: 10.1016/0002-9149(84)90565-4.
The clinical characteristics and nonsurgical prognosis of 55 patients with "left main (LM) equivalent" coronary artery disease (CAD) were evaluated and defined as: (1) greater than or equal to 75% diameter reduction of the left anterior descending coronary artery (LAD) before the takeoff of any large septal perforator or anterolateral (diagonal) branches; (2) greater than or equal to 75% diameter reduction of the left circumflex artery (LC) before the takeoff of any large marginal branch; and (3) absence of greater than or equal to 50% stenosis of the LM coronary artery. Compared with nonsurgically treated patients with greater than or equal to 75% stenosis of the LM artery, patients with LM equivalent CAD had a shorter duration of symptoms (median of 51 months vs 66 months) and more often had a Q wave on the electrocardiogram (60 vs 39%). Survival in patients with LM equivalent CAD (78% at 1 year and 55% at 5 years) was better than that in patients with LM disease with nonsurgical therapy (65% at 1 year and 40% at 5 years) (p = 0.02), although the rate of freedom from cardiovascular events was not significantly different. Compared with other nonsurgically treated patients with 2- or 3-vessel CAD involving the LAD and LC (28 and 42%, respectively, with progressive angina), patients with LM equivalent CAD had more severe anginal symptoms (55% with progressive angina) and a longer duration of symptoms (medians of 20 months in 2-vessel CAD, 36 months in 3-vessel CAD and 51 months in LM equivalent CAD).(ABSTRACT TRUNCATED AT 250 WORDS)
对55例“左主干（LM）等同”冠心病（CAD）患者的临床特征及非手术预后进行了评估，其定义为：（1）在任何大的间隔穿支或前外侧（对角）分支发出之前，左前降支冠状动脉（LAD）直径减少≥75%；（2）在任何大的边缘分支发出之前，左旋支动脉（LC）直径减少≥75%；（3）LM冠状动脉狭窄<50%。与非手术治疗的LM动脉狭窄≥75%的患者相比，LM等同CAD患者的症状持续时间较短（中位数为51个月对66个月），且心电图上出现Q波的情况更常见（60%对39%）。LM等同CAD患者的生存率（1年时为78%，5年时为55%）优于非手术治疗的LM疾病患者（1年时为65%，5年时为40%）（p=0.02），尽管无心血管事件发生率无显著差异。与其他非手术治疗的累及LAD和LC的2支或3支CAD患者（分别有28%和42%发生进行性心绞痛）相比，LM等同CAD患者的心绞痛症状更严重（55%发生进行性心绞痛），且症状持续时间更长（2支CAD患者中位数为20个月，3支CAD患者为36个月，LM等同CAD患者为51个月）。（摘要截取自250字）
