Barrillon A, Kusmierek J, Rochemaure J, Gerbaux A
Arch Mal Coeur Vaiss. 1975 Feb;68(2):147-56.
Report of an anatomical-clinical study concerning 173 patients with an average follow-up period of 5 and 1/2 years after the onset of myocardial infarction. They were subdivided into four comparable groups differing only in the quality of the long-term antivitamin K treatment which was administered. A survey of the coronary artery and myocardial lesions was performed for every heart. Acute occlusive coronary artery thromboses were four times less frequent in the correctly treated group then in the other three groups (p less than 0.001). There was no significant difference between the insufficiently treated groups and the untreated group. Recurrent myocardial infarctions were accompanied in 90 per cent of cases by acute occlusive coronary artery thromboses and were four times less frequent when treatment was efficient (p less than 0.001). These results confirm the part played by coronary artery thrombosis in the aggravation of coronary atherosclerosis and justify the attempts at long-term prophylaxis. The provide the proof that antivitamin K administration, at efficient dosage, maintained for a long time, has a significant influence on the cause of death in these patients, by decreasing the number of coronary artery thrombosis. Long-term anticoagulant treatment, in spite of its haemorrhagic complications and limits, should not be given up until a new efficient treatment is available.
一项解剖学临床研究报告，涉及173例心肌梗死发病后平均随访5年半的患者。他们被分为四个可比组，仅在长期服用抗维生素K治疗的质量上有所不同。对每颗心脏进行了冠状动脉和心肌病变的调查。正确治疗组急性冠状动脉闭塞性血栓形成的发生率比其他三组低四倍（p<0.001）。治疗不足组和未治疗组之间无显著差异。90%的复发性心肌梗死伴有急性冠状动脉闭塞性血栓形成，有效治疗时其发生率低四倍（p<0.001）。这些结果证实了冠状动脉血栓形成在冠状动脉粥样硬化加重中所起的作用，并证明了长期预防的尝试是合理的。它们提供了证据，即长期以有效剂量服用抗维生素K，通过减少冠状动脉血栓形成的数量，对这些患者的死因有重大影响。长期抗凝治疗尽管有出血并发症和局限性，但在有新的有效治疗方法之前不应放弃。
