Rossi L, Carbonieri E, Rossetti L, Tomei R, Franceschini L, Tomé S, Vassanelli C, Zardini P
Cattedra e Divisione Clinicizzata di Cardiologia, Università degli Studi, Verona.
Cardiologia. 1995 Feb;40(2):93-9.
Short-term outcome after coronary angioplasty is mainly determined by restenosis, while long-term outcome is determined by new events due to incomplete revascularization, by atherosclerosis progression and by late-restenosis. The aim of this study is to assess if correctly treated coronary risk factors are predictors of poor prognosis after coronary angioplasty. Two-hundred and twenty six patients (209 males, 17 females, mean age 56 +/- 9 years) with successful coronary angioplasty were treated for coronary risk factors. New events (death, myocardial infarction, repeat angioplasty, bypass surgery) were recorded. Ischemia was evaluated by serial exercise tests. The mean follow-up was 31 +/- 12 months. Survival was 99.5% at 1 year and 97.4% after 5 years; "event free survival" was 84.6% at 1 year and 65.9% after 5 years; "ischemia free survival" was 84.6% at 1 year and 44.8% after 5 years. "Ischemia free survival" was higher in patients with single coronary angioplasty and in patients with infarct-related vessel angioplasty. Smoke addiction, diabetes, hypercholesterolemia and hypertension were not significantly correlated with "ischemia free survival". Smokers and diabetics had a trend towards a less favorable 5 year outcome, but without statistical differences. In conclusion, this study shows that correctly treated coronary risk factors do not worsen prognosis after coronary angioplasty.
冠状动脉血管成形术后的短期预后主要由再狭窄决定，而长期预后则由不完全血运重建导致的新事件、动脉粥样硬化进展和晚期再狭窄决定。本研究的目的是评估正确治疗的冠状动脉危险因素是否是冠状动脉血管成形术后预后不良的预测因素。226例（209例男性，17例女性，平均年龄56±9岁）成功进行冠状动脉血管成形术的患者接受了冠状动脉危险因素治疗。记录新事件（死亡、心肌梗死、再次血管成形术、搭桥手术）。通过系列运动试验评估缺血情况。平均随访时间为31±12个月。1年生存率为99.5%，5年后为97.4%；“无事件生存率”1年时为84.6%，5年后为65.9%；“无缺血生存率”1年时为84.6%，5年后为44.8%。单支冠状动脉血管成形术患者和梗死相关血管血管成形术患者的“无缺血生存率”较高。吸烟成瘾、糖尿病、高胆固醇血症和高血压与“无缺血生存率”无显著相关性。吸烟者和糖尿病患者5年预后有较差的趋势，但无统计学差异。总之，本研究表明，正确治疗的冠状动脉危险因素不会使冠状动脉血管成形术后的预后恶化。
