Russell R O, Rackley C E, Kouchoukos N T
Circulation. 1982 Jun;65(7 Pt 2):72-7. doi: 10.1161/01.cir.65.7.72.
Several prospective randomized studies of medical or surgical therapy have not shown that either form of management alone is uniformly superior with respect to mortality for unstable angina pectoris. Patients managed medically have a greater incidence of angina pectoris. Earlier studies indicated a higher rate of nonfatal myocardial infarction with urgent surgery. Present management includes hospitalization and early intensive medical therapy with nitrates and, usually, beta-blocking agents. Coronary arteriography is advised within a few days. If the patient has left main coronary artery disease or three-vessel disease, early coronary artery bypass graft surgery within days to a couple of weeks is advised. Otherwise, medical management is advised and elective surgery can be performed if the patient remains symptomatic.
几项关于药物治疗或手术治疗的前瞻性随机研究并未表明，对于不稳定型心绞痛，单独的任何一种治疗方式在死亡率方面都始终具有优势。接受药物治疗的患者心绞痛发生率更高。早期研究表明，紧急手术的非致命性心肌梗死发生率较高。目前的治疗包括住院和早期强化药物治疗，使用硝酸盐类药物，通常还会使用β受体阻滞剂。建议在几天内进行冠状动脉造影。如果患者患有左主干冠状动脉疾病或三支血管病变，建议在数天至几周内尽早进行冠状动脉搭桥手术。否则，建议进行药物治疗，如果患者仍有症状，可以进行择期手术。
