Rivier J L, Cardinaux J, Sadeghi H
Schweiz Med Wochenschr. 1981 Jan 17;111(3):82-4.
The prognosis in patients with mild or moderate angina pectoris (class I or I-II) and significant coronary artery lesions (70% or more luminal diameter reduction) is controversial. Since 1967 these cases have not been operated upon in our Division. To assess the justice of this approach, 61 mildly symptomatic, non-operated patients (group I) were compared with 65 markedly symptomatic (class II to IV) patients in whom coronary artery bypass procedures were indicated but not performed (group II). These patients either had refused surgery or the lesions were considered unsuited to revascularization. Although 44 patients in group I had 70% or more stenosis of one or more coronary arteries, the 8-year mortality rate in group I was 17% compared with 40% in group II. For patients with single vessel disease (32 patients in group I, 35 patients in group II) the 8-year mortality was 9.4% in group I and 34% in group II; the difference is significant. This retrospective study suggests that mild and moderate angina pectoris (class I or I-II with or without medical treatment) is associated with a rather favourable prognosis (one single death during the first four years in group I). It may be concluded that an aggressive approach can be delayed until further symptoms develop despite adequate medical therapy.
轻度或中度心绞痛（I级或I-II级）且有明显冠状动脉病变（管腔直径缩小70%或更多）患者的预后存在争议。自1967年以来，我们科室未对这些病例进行手术。为评估这种做法的合理性，将61例症状轻微、未接受手术的患者（I组）与65例症状明显（II至IV级）、虽有冠状动脉搭桥手术指征但未进行手术的患者（II组）进行了比较。这些患者要么拒绝手术，要么病变被认为不适合血运重建。尽管I组中有44例患者一支或多支冠状动脉狭窄达70%或更多，但I组的8年死亡率为17%，而II组为40%。对于单支血管病变患者（I组32例，II组35例），I组的8年死亡率为9.4%，II组为34%；差异具有统计学意义。这项回顾性研究表明，轻度和中度心绞痛（I级或I-II级，无论是否接受药物治疗）的预后相当良好（I组在前四年仅有1例死亡）。可以得出结论，尽管进行了充分的药物治疗，但在出现进一步症状之前，可以推迟采取积极的治疗方法。
