Ringqvist I, Fisher L D, Mock M, Davis K B, Wedel H, Chaitman B R, Passamani E, Russell R O, Alderman E L, Kouchoukas N T, Kaiser G C, Ryan T J, Killip T, Fray D
J Clin Invest. 1983 Jun;71(6):1854-66. doi: 10.1172/jci110941.
The Coronary Artery Surgery Study, CASS, enrolled 24,959 patients between August 1975 and June 1979 who were studied angiographically for suspected coronary artery disease. This paper compares the prognostic value for survival without early elective surgery of eight different indices of the extent of coronary artery disease: the number of diseased vessels, two indices using the number of proximal arterial segments diseased, two empirically generated indices from the CASS data, and the published indices of Friesinger, Gensini, and the National Heart and Chest Hospital, London. All had considerable prognostic information. Typically 80% of the prognostic information in one index was also contained in another. Our analysis shows that good prediction from angiographic data results from a combination of left ventricular function and arteriographic extent of disease. Prognosis may reasonably be obtained from three simple indices: the number of vessels diseased, the number of proximal arterial segments diseased, and a left ventricular wall motion score. These three indices account for an estimated 84% of the prognostic information available. 6-yr survival varies between 93 and 16% depending upon the values of these three indices.
冠状动脉外科研究（CASS）在1975年8月至1979年6月期间招募了24959名患者，这些患者因疑似冠状动脉疾病接受了血管造影检查。本文比较了冠状动脉疾病严重程度的八个不同指标对未经早期择期手术患者生存的预后价值：病变血管数量、两个使用病变近端动脉节段数量的指标、两个根据CASS数据经验得出的指标，以及已发表的弗里辛格、詹西尼和伦敦国家心脏与胸科医院的指标。所有这些指标都包含大量预后信息。通常，一个指标中80%的预后信息也包含在另一个指标中。我们的分析表明，血管造影数据的良好预测源于左心室功能和疾病血管造影严重程度的结合。通过三个简单指标可以合理地得出预后：病变血管数量、病变近端动脉节段数量和左心室壁运动评分。这三个指标约占可用预后信息的84%。根据这三个指标的值，6年生存率在93%至16%之间变化。
