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[35岁以下患者冠状动脉腔内血管成形术的近期和远期结果]

[Immediate and long-term results of coronary transluminal angioplasty in patients under 35 years of age].

作者信息

Colasante B, Buffet P, Feldmann L, Danchin N, Juillière Y, Anconina J, Cuillière M, Cherrier F

机构信息

Service de cardiologie A, CHU Nancy-Brabois, Vandoeuvre-les-Nancy.

出版信息

Arch Mal Coeur Vaiss. 1993 Jun;86(6):875-9.

PMID:8274059
Abstract

Over an eleven year period, 57 patients under 35 years of age underwent percutaneous transluminal coronary angioplasty (PTCA). The features of the study population were: 55 men and 2 women, average age 32 +/- 3 years; unstable angina in 30%, previous myocardial infarction in 53%, average left ventricular ejection fraction 59 +/- 12%, single vessel disease in 84%. A total of 63 vessels were dilated. The primary success rate was 81% (72% in the first 29 patients compared with 89% in the latter 28 patients, p = 0.1). The following complications were observed: peri-procedural infarction (4 cases), emergency coronary bypass surgery (4 cases), no fatalities. During follow-up (average 6 +/- 3 years), of the 43 patients who underwent control coronary angiography in the last 6 months, 14 (33%) had angiographic restenosis. The long-term outcome was marked by 5 coronary bypass operations (3 for restenosis, 1 after failure of PTCA and 1 for progression of the coronary disease), 8 PTCAs for a new lesion due to progression of the coronary disease, 2 deaths and 2 non-lethal infarctions. The 10 year survival was 96 +/- 3% and the survival rate without cardiac events (infarction, surgical revascularisation or repeat PTCA) was 62 +/- 10% at 10 years. Of the 54 survivors, 50 (92%) have no angina, and 44 (81%) continue to take antiischaemic drug therapy. Of the 50 patients who were in full employment, 37 (74%) have gone back to full-time working and 8 (16%) have taken part-time jobs. (ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在11年期间,57名35岁以下的患者接受了经皮腔内冠状动脉成形术(PTCA)。研究人群的特征如下:55名男性和2名女性,平均年龄32±3岁;30%患有不稳定型心绞痛,53%有过心肌梗死病史,平均左心室射血分数为59±12%,84%为单支血管病变。共扩张了63条血管。首次成功率为81%(前29例患者中为72%,后28例患者中为89%,p = 0.1)。观察到以下并发症:围手术期梗死(4例)、急诊冠状动脉搭桥手术(4例),无死亡病例。在随访期间(平均6±3年),在最后6个月接受冠状动脉造影复查的43例患者中,14例(33%)出现造影剂再狭窄。长期结果表现为5例冠状动脉搭桥手术(3例因再狭窄,1例PTCA失败后,1例因冠状动脉疾病进展),8例因冠状动脉疾病进展出现新病变而进行的PTCA,2例死亡和2例非致命性梗死。10年生存率为96±3%,10年无心脏事件(梗死、外科血运重建或重复PTCA)的生存率为62±10%。在54名幸存者中,50名(92%)无心绞痛,44名(81%)继续服用抗缺血药物治疗。在50名全职工作的患者中,37名(74%)已恢复全职工作,8名(16%)从事兼职工作。(摘要截取自250字)

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