Chevalier L, Koch M, Hajjar M, Douard H, Broustet J P
Hôpital cardiologique du Haut-Lévêque, Pessac.
Arch Mal Coeur Vaiss. 1995 Feb;88(2):181-7.
In the period between September 1979 and December 1986, 105 out of 2,178 consecutive patients with coronary artery disease (men 93, women 12; age : 58.1 +/- 10 years; previous myocardial infarction : 67%) were considered inoperable because of poor distal coronary circulation (84.8%), left ventricular dysfunction (3.8%) or both (11.4%). Fifty-four clinical, ergometric and angiographic parameters were examined at inclusion. The mean follow-up was 69 +/- 40.2 months (1 to 146 months). The Kaplan Meier 10 year survival rate was 43%. Only 25% of the population remained free of major cardiac events. Multivariate analysis showed that only the coronary angiographic score had a significant predictive value. The authors conclude that the long-term prognosis of these patients is poor. Some did undergo coronary bypass surgery secondarily, and their prognosis was good, suggesting that revascularisation, even if only partial and at high risk, should be considered.
在1979年9月至1986年12月期间，2178例连续性冠心病患者中，有105例（男性93例，女性12例；年龄：58.1±10岁；既往有心肌梗死：67%）因冠状动脉远端循环不良（84.8%）、左心室功能障碍（3.8%）或两者皆有（11.4%）而被认为无法进行手术。纳入时检查了54项临床、运动测试和血管造影参数。平均随访时间为69±40.2个月（1至146个月）。Kaplan Meier法计算的10年生存率为43%。只有25%的患者未发生重大心脏事件。多因素分析显示，只有冠状动脉造影评分具有显著的预测价值。作者得出结论，这些患者的长期预后较差。一些患者随后接受了冠状动脉搭桥手术，其预后良好，这表明即使只是部分且高风险的血运重建也应予以考虑。
