Weintraub W S, Jones E L, Craver J M, Guyton R A
Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.
Am J Cardiol. 1994 Jan 15;73(2):103-12. doi: 10.1016/0002-9149(94)90198-8.
This study examines the long-term frequency of reoperative coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) after CABG. The source of data was the clinical database at Emory University Hospitals. The population comprised 3,480 patients undergoing a first CABG between 1978 and 1981. Event-free survival was determined using the Kaplan-Meier method and determinants of survival with the Cox proportional-hazards model. The in-hospital mortality was 1.0% and 5-, 10- and 12-year survival was 91, 78 and 70%. The 5-, 10- and 12-year freedom from reoperative CABG was 98, 88 and 80%. The 5-, 10- and 12-year freedom from PTCA was 98, 91 and 85%. The 5-, 10- and 12-year freedom from either CABG or PTCA was 96, 81 and 69%. Younger patients had much higher incidences of repeat procedures. The yearly incidence of repeat procedures accelerated over time. These data reveal the ultimately palliative nature of revascularization for coronary artery disease.
本研究调查了冠状动脉旁路移植术（CABG）术后再次行冠状动脉旁路移植术及经皮腔内冠状动脉成形术（PTCA）的长期发生率。数据来源于埃默里大学医院的临床数据库。研究对象为1978年至1981年间接受首次冠状动脉旁路移植术的3480例患者。采用Kaplan-Meier法确定无事件生存率，并使用Cox比例风险模型确定生存的决定因素。住院死亡率为1.0%，5年、10年和12年生存率分别为91%、78%和70%。5年、10年和12年免于再次冠状动脉旁路移植术的比例分别为98%、88%和80%。5年、10年和12年免于经皮腔内冠状动脉成形术的比例分别为98%、91%和85%。5年、10年和12年免于冠状动脉旁路移植术或经皮腔内冠状动脉成形术的比例分别为96%、81%和69%。年轻患者再次手术的发生率要高得多。再次手术的年发生率随时间加速上升。这些数据揭示了冠状动脉疾病血运重建最终的姑息性质。
