Ciraulo D A, Bresnahan G F, Frankel P S, Isely P E, Zimmerman W R, Chesne R B
Chest. 1983 Feb;83(2):196-202. doi: 10.1378/chest.83.2.196.
Angiographic, clinical, and five-year follow-up study of 20 cases of myocardial infarction with normal coronary angiograms (MI-NCA) and 20 cases of myocardial infarction with single vessel obstruction (MI-SVO) are presented. MI-SVO patients differed from MI-NCA in being older (53.7 vs 44.5 years, p = 0.025), predominantly male (90 percent vs 40 percent, p = 0.001), frequently having large left ventricular akinetic segments (50 percent vs 15 percent, p = 0.01), and frequently having antecedent typical angina (55 percent). MI-NCA was more frequently associated with definite mitral valve prolapse (25 percent vs 10 percent, NS); migraine, or Raynaud's phenomenon (45 percent vs 5 percent, p = 0.001); birth control pill ingestion in women (33 percent vs 0 percent, p = 0.05); paroxysmal atrial flutter (25 percent vs 0 percent, p = 0.01); and antecedent atypical angina (25 percent). Frequency of cigarette smoking and hypertension and the mean serum cholesterol levels were similar in both groups. On follow-up, MI-NCA patients more commonly had neurologic events (25 percent vs 5 percent, p = 0.05) and second myocardial infarction (15 percent vs 0 percent, p = 0.02), but deaths occurred infrequently in both groups. These data suggest a variety of pathophysiologic causes for MI-NCA.
本文介绍了20例冠状动脉造影正常的心肌梗死（MI-NCA）患者和20例单支血管阻塞的心肌梗死（MI-SVO）患者的血管造影、临床及五年随访研究。MI-SVO患者与MI-NCA患者的不同之处在于，前者年龄较大（53.7岁对44.5岁，p = 0.025），男性居多（90%对40%，p = 0.001），经常出现大面积左心室运动减弱节段（50%对15%，p = 0.01），且经常有前驱典型心绞痛（55%）。MI-NCA更常与明确的二尖瓣脱垂相关（25%对10%，无显著性差异）；偏头痛或雷诺现象（45%对5%，p = 0.001）；女性服用避孕药（33%对0%，p = 0.05）；阵发性心房扑动（25%对0%，p = 0.01）；以及前驱非典型心绞痛（25%）。两组的吸烟频率、高血压患病率及平均血清胆固醇水平相似。随访时，MI-NCA患者更常发生神经系统事件（25%对5%，p = 0.05）和再次心肌梗死（15%对0%，p = 0.02），但两组死亡均不常见。这些数据提示MI-NCA存在多种病理生理原因。
