Thomas D
Service de Cardiologie, Groupe hospitalier Pitié-Salpêtnère, Paris.
Rev Prat. 1995 Jan 1;45(1):44-9.
The prevalence of coronary artery disease is very high among patients with peripheral arterial disease. The fate of these patients mainly depends on their coronary risk. Most often, the evaluation of coronary risk is performed when a surgical intervention on the aorta or lower limb arteries is decided. However, the late risk, at medium and long term, of coronary disease is much higher than its immediate perioperative risk. Diagnostic work-up is complex. Symptoms of coronary insufficiency may be masked by the limited capacity to physical exercise, but remain essential indices. None of the available complementary investigations has a satisfactory predictive value. Diagnostic explorations and therapeutic decisions for coronary heart disease have to be discussed in each case, according mainly to age and symptoms, and to whether peripheral arterial surgery is required.
外周动脉疾病患者中冠状动脉疾病的患病率非常高。这些患者的预后主要取决于其冠状动脉风险。大多数情况下，当决定对主动脉或下肢动脉进行手术干预时，会对冠状动脉风险进行评估。然而，冠心病的中长期远期风险远高于其围手术期即时风险。诊断检查很复杂。冠状动脉供血不足的症状可能会因体育锻炼能力受限而被掩盖，但仍然是重要指标。现有的辅助检查均没有令人满意的预测价值。对于冠心病的诊断性检查和治疗决策，必须根据每个病例的具体情况进行讨论，主要依据年龄、症状以及是否需要进行外周动脉手术。
