Brown K A, Boucher C A, Okada R D, Guiney T E, Newell J B, Strauss H W, Pohost G M
J Am Coll Cardiol. 1983 Apr;1(4):994-1001. doi: 10.1016/s0735-1097(83)80100-4.
Accurate prognostic information is important in determining optimal management of patients presenting for evaluation of chest pain. In this study, the ability of exercise thallium-201 myocardial imaging to predict future cardiac events (cardiovascular death or nonfatal myocardial infarction) was correlated with clinical, coronary and left ventricular angiographic and exercise electrocardiographic data in 139 consecutive, nonsurgically managed patients followed-up over a 3 to 5 year period (mean follow-up, 3.7 +/- 0.9), using a logistic regression analysis. Among patients without prior myocardial infarction (100 of 139), the number of myocardial segments with transient thallium-201 defects was the only statistically significant predictor of future cardiac events when all patient variables were evaluated. Among patients with myocardial infarction before evaluation (39 of 139), angiographic ejection fraction was the only significant predictor of future cardiac events when all variables were considered. This study suggests an approach to evaluate the risk of future cardiac events in patients with possible ischemic heart disease.
准确的预后信息对于确定胸痛待评估患者的最佳治疗方案至关重要。在本研究中，采用逻辑回归分析，对139例连续的非手术治疗患者进行了3至5年（平均随访3.7±0.9年）的随访，将运动铊-201心肌显像预测未来心脏事件（心血管死亡或非致命性心肌梗死）的能力与临床、冠状动脉及左心室血管造影和运动心电图数据进行了关联分析。在无既往心肌梗死的患者（139例中的100例）中，当评估所有患者变量时，出现短暂铊-201缺损的心肌节段数是未来心脏事件唯一具有统计学意义的预测指标。在评估前有心肌梗死的患者（139例中的39例）中，当考虑所有变量时，血管造影射血分数是未来心脏事件唯一的显著预测指标。本研究提示了一种评估可能患有缺血性心脏病患者未来心脏事件风险的方法。
