Hosoda S, Kimata S, Tamura K, Nakamura M, Toshima H, Shibata J, Minamino R, Takano T, Hiramori K, Yaginuma T
Tokyo Women's Medical College, Heart Institute of Japan.
Jpn Circ J. 1995 Mar;59(3):121-9. doi: 10.1253/jcj.59.121.
Two thousand, seven hundred and thirty-three patients with acute myocardial infarction (AMI) who were admitted to our 11 institutions between 1983 and 1988, examined by coronary arteriography and discharged alive, were followed for an average of 2.9 years. During the follow-up period, 212 patients (7.6%) died. The factors that governed the prognosis of myocardial infarction after discharge were advanced age, female gender, obesity, previous infarction, angina pectoris more than 1 month before the onset of AMI, post-infarction angina, multiple-vessel diseases, advanced stage by Killip's and/or Forrester's classification on admission, elevated pulmonary capillary arterial pressure, decreased cardiac index, decreased left ventricular ejection fraction, increased left ventricular end-diastolic volume and left ventricular aneurysm before hospital discharge. Patients with ventricular tachycardia or ventricular fibrillation during hospitalization showed a poor prognosis. In contrast, patients who received intracoronary thrombolysis, or emergent and/or elective percutaneous transluminal coronary angioplasty showed a favorable prognosis.
1983年至1988年间，我们11家机构收治的2733例急性心肌梗死（AMI）患者，经冠状动脉造影检查且存活出院，平均随访2.9年。随访期间，212例患者（7.6%）死亡。出院后影响心肌梗死预后的因素包括高龄、女性、肥胖、既往梗死史、AMI发病前1个月以上的心绞痛、梗死后心绞痛、多支血管病变、入院时Killip和/或Forrester分级的晚期、肺毛细血管动脉压升高、心脏指数降低、左心室射血分数降低、左心室舒张末期容积增加以及出院前左心室室壁瘤。住院期间发生室性心动过速或心室颤动的患者预后较差。相比之下，接受冠状动脉内溶栓或急诊和/或择期经皮腔内冠状动脉成形术的患者预后良好。
