Vanhaecke J, Piessens J, Willems J L, De Geest H
Am J Cardiol. 1981 Apr;47(4):810-4. doi: 10.1016/0002-9149(81)90178-8.
An analysis was made of clinical and electrocardiographic prognostic determinants of multiple vessel disease in 100 men, aged under 45 years, who survived a myocardial infarction. All patients underwent selective coronary arteriography within 1 year after sustaining a myocardial infarction. Multivessel disease was present in 64 patients; 33 patients had single vessel disease and 3 had either normal coronary arteries or minimal lesions. Exercise stress testing, electrocardiographic location of the infarction, total serum cholesterol and clinical features including body build, arterial blood pressure, smoking habits, family history of coronary artery disease and the presence of angina pectoris either before or after the acute event proved to be poor predictors of multiple vessel disease. Only 74 percent of the patients were correctly classified by a discriminant function analysis. Thus, for prognostic reasons, coronary arteriography seems warranted in young patients after acute myocardial infarction, even in the absence of residual angina or multiple risk factors.
对100名年龄在45岁以下且心肌梗死后存活的男性患者的多支血管病变的临床和心电图预后决定因素进行了分析。所有患者在发生心肌梗死后1年内均接受了选择性冠状动脉造影。64例患者存在多支血管病变；33例患者为单支血管病变，3例患者冠状动脉正常或仅有轻微病变。运动负荷试验、梗死的心电图定位、血清总胆固醇以及包括体型、动脉血压、吸烟习惯、冠状动脉疾病家族史和急性事件前后是否存在心绞痛在内的临床特征，均被证明是多支血管病变的不良预测指标。通过判别函数分析，只有74%的患者被正确分类。因此，出于预后考虑，即使在没有残余心绞痛或多种危险因素的情况下，对于急性心肌梗死后的年轻患者，冠状动脉造影似乎也是必要的。
