Scott N A, Kelsey S F, Detre K, Cowley M, King S B
Andreas R. Gruentzig Cardiovascular Center, Emory University Hospital, Atlanta, Georgia 30322.
Am J Cardiol. 1994 Jun 15;73(16):1141-6. doi: 10.1016/0002-9149(94)90171-6.
Although black patients have a higher prevalence of risk factors for coronary artery disease, the outcome of coronary angioplasty in black patients is not known. The purpose of this study was to determine if any racial differences existed in the clinical characteristics and outcome of patients enrolled in the 1985-1986 National Heart, Lung, and Blood Institute (NHLBI) Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry. The clinical characteristics, in-hospital event rates, and 5-year follow-up results of all patients enrolled in the 1985-1986 NHLBI PTCA Registry were examined with respect to race. Of the patients enrolled in the registry, 1,939 (90.8%) were white and 76 (3.6%) were black. Among black patients there were more women (50% vs 24%, p < 0.001), and more patients who had hypertension (73% vs 45%, p < 0.001) and diabetes (23% vs 13%, p < 0.05). Black patients were more likely to have multivessel disease (72% vs 48%, p < 0.001). Clinical success rates were similar (76.3% for blacks and 79.3% for whites), but because black patients had more vessels with significant disease, complete revascularization was achieved in 26% of black patients compared with 44% of white patients (p < 0.001). After the PTCA procedure there was no significant difference in major complications (death, myocardial infarction, or emergent coronary artery bypass grafting) between the 2 groups. Five-year follow-up data revealed that there was no significant difference in mortality, myocardial infarction, coronary artery bypass grafting, or repeat PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管黑人患者患冠状动脉疾病的危险因素患病率较高,但黑人患者冠状动脉血管成形术的结果尚不清楚。本研究的目的是确定在1985 - 1986年美国国立心肺血液研究所(NHLBI)经皮腔内冠状动脉血管成形术(PTCA)登记处登记的患者的临床特征和结果中是否存在任何种族差异。对1985 - 1986年NHLBI PTCA登记处登记的所有患者的临床特征、住院事件发生率和5年随访结果进行了种族方面的检查。在登记的患者中,1939名(90.8%)为白人,76名(3.6%)为黑人。黑人患者中女性更多(50%对24%,p<0.001),患有高血压的患者更多(73%对45%,p<0.001)以及糖尿病的患者更多(23%对13%,p<0.05)。黑人患者更有可能患有多支血管病变(72%对48%,p<0.001)。临床成功率相似(黑人患者为76.3%,白人患者为79.3%),但由于黑人患者有更多严重病变的血管,26%的黑人患者实现了完全血运重建,而白人患者为44%(p<0.001)。PTCA手术后,两组之间的主要并发症(死亡、心肌梗死或急诊冠状动脉搭桥术)没有显著差异。5年随访数据显示,在死亡率、心肌梗死、冠状动脉搭桥术或再次PTCA方面没有显著差异。(摘要截断于250字)