Puletti M, Staropoli P, Molaioni C, Matteoli S, Trappolini M, Curione M
II Clinica Medica, Università di Roma, La Sapienza.
Minerva Cardioangiol. 1995 Jan-Feb;43(1-2):1-6.
In the last decade advances in cardiovascular research improved remarkably our understanding of coronary heart disease. However many important problems are so far unresolved. In the present study we focused on the "natural" history of ischemic heart disease in a group of 114 patients. One hundred-seven patients had recent myocardial infarction, and seven suffered from angina. They were observed for a mean period of five years (one to 168 months). Forty-nine patients (42.9%) had no coronary events; sixty-five had angina, myocardial infarction or both. The myocardial infarction was however rare (five cases). The most frequent presentation of angina was stable and effort angina, which sometimes subsided after a period of presence. The classification of angina was often very difficult in cases of effort angina with very low threshold. No relevant differences were found between patients with and without coronary events according to age, sex, duration of follow-up, location of previous myocardial infarction. A significant difference was found in the prevalence of risk factors only for hypertension, which was more frequent in patients with coronary events. Smokers were more frequent in group without coronary events. In our opinion, the most interesting conclusion is that, almost half of these patients remained completely asymptomatic for a very long period.
在过去十年中,心血管研究的进展显著增进了我们对冠心病的理解。然而,许多重要问题至今仍未得到解决。在本研究中,我们聚焦于114例患者的缺血性心脏病“自然”病史。其中107例患者近期发生心肌梗死,7例患有心绞痛。他们的平均观察期为五年(1至168个月)。49例患者(42.9%)未发生冠状动脉事件;65例出现心绞痛、心肌梗死或两者皆有。不过,心肌梗死较为罕见(5例)。最常见的心绞痛表现为稳定型劳力性心绞痛,有时在持续一段时间后会缓解。对于阈值极低的劳力性心绞痛病例,心绞痛的分类往往非常困难。根据年龄、性别、随访时间、既往心肌梗死部位,发生和未发生冠状动脉事件的患者之间未发现相关差异。仅在危险因素的患病率方面发现了显著差异,即高血压在发生冠状动脉事件的患者中更为常见。在未发生冠状动脉事件的组中吸烟者更为常见。我们认为,最有趣的结论是,这些患者中几乎一半在很长一段时间内完全无症状。