Berlinerblau R, Shani J
Department of Medicine, Maimonides Medical Center, Brooklyn, New York 11219.
J Am Coll Cardiol. 1994 Mar 1;23(3):627-9. doi: 10.1016/0735-1097(94)90746-3.
This study was designed to determine the severity of coronary artery disease in patients with postprandial angina pectoris.
Postprandial angina is a manifestation of coronary artery disease. Although seen in clinical practice, very little has been published about the syndrome, and no anatomic correlations have been described.
Questionnaires were given to 408 patients with chest pain and objective evidence of ischemia. Thirty-five patients (8.6%) were identified as having postprandial angina (Group A). The other 373 patients (Group B) had nonpostprandial angina and served as the control group. Coronary angiography was performed in all patients, and the results were analyzed.
Postprandial angina was observed predominantly in men (91% vs. 66%, p = 0.0036). It was associated with a high incidence of rest angina (83% in Group A vs. 51% in Group B, p = 0.0005) and a very high incidence of left main (34% vs. 10%, p = 0.0001) and three-vessel (82% vs. 54%, p = 0.001) coronary artery disease. The ejection fraction was lower as well in these patients (0.39 vs. 0.47, p = 0.046). Postprandial angina occurred at rest and on exertion, most commonly after dinner.
Postprandial angina is a likely marker of severe coronary artery disease and should be considered an indication for coronary angiography.
本研究旨在确定餐后心绞痛患者冠状动脉疾病的严重程度。
餐后心绞痛是冠状动脉疾病的一种表现。尽管在临床实践中可见，但关于该综合征的报道极少，且尚未描述其与解剖结构的相关性。
对408例有胸痛且有缺血客观证据的患者进行问卷调查。35例患者（8.6%）被确定为患有餐后心绞痛（A组）。其他373例患者（B组）患有非餐后心绞痛，作为对照组。所有患者均进行冠状动脉造影，并对结果进行分析。
餐后心绞痛主要见于男性（91%对66%，p = 0.0036）。它与静息心绞痛的高发生率（A组为83%，B组为51%，p = 0.0005）以及左主干（34%对10%，p = 0.0001）和三支血管（82%对54%，p = 0.001）冠状动脉疾病的极高发生率相关。这些患者的射血分数也较低（0.39对0.47，p = 0.046）。餐后心绞痛在静息时和运动时均有发生，最常见于晚餐后。
餐后心绞痛可能是严重冠状动脉疾病的一个标志，应被视为冠状动脉造影的一个指征。
