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[稳定型和不稳定型心绞痛球囊扩张术后10年的长期病程]

[Long term course over 10 years after balloon dilatation in stable and unstable angina pectoris].

作者信息

Espinola-Klein C, Rupprecht H J, Trautmann S, Nafe B, Erbel R, Brennecke R, Pop T, Meyer J

机构信息

II. Medizinische Klinik, Universität Mainz.

出版信息

Dtsch Med Wochenschr. 1996 May 3;121(18):577-82. doi: 10.1055/s-2008-1043042.

Abstract

OBJECTIVE

To assess the cardiac status of patients ten years after percutaneous transluminal coronary artery angioplasty (PTCA).

PATIENTS AND METHODS

Data of 534 patients (436 men, 98 women; mean age 53.2 +/- 8 years) in whom a PTCA had been performed between 1983 and 1986 were analysed, based on a questionnaire answered 121 +/- 11 months after the initial procedure. At the time of PTCA 184 patients (35%) had unstable angina, 350 (65%) stable angina.

RESULTS

116 patients (63%) with unstable angina and 164 (47%) with stable angina had at least one cardiac event after the initial PTCA (repeat PTCA, bypass operation, myocardial infarction, death). None of these events occurred in 68 patients (37%) with unstable or in 186 (53%) with stable angina (P < 0.001). After 10 years 196 of the 302 surviving patients with stable angina (65%) and 104 of the 153 surviving patients with unstable angina (68%) were symptom-free.

CONCLUSIONS

Ten-year follow-up after PTCA has shown that cardiac events are significantly more frequent in patients who had had unstable angina than in those with stable angina. This difference already develops in the first year post-PTCA, with no increase later. Symptoms are lastingly improved after 10 years in both groups of patients.

摘要

目的

评估经皮腔内冠状动脉成形术(PTCA)十年后患者的心脏状况。

患者与方法

分析了1983年至1986年间接受PTCA的534例患者(436例男性,98例女性;平均年龄53.2±8岁)的数据,这些数据基于首次手术后121±11个月时回答的一份问卷。在PTCA时,184例患者(35%)患有不稳定型心绞痛,350例(65%)患有稳定型心绞痛。

结果

116例(63%)不稳定型心绞痛患者和164例(47%)稳定型心绞痛患者在首次PTCA后至少发生了一次心脏事件(重复PTCA、搭桥手术、心肌梗死、死亡)。这些事件在68例(37%)不稳定型心绞痛患者或186例(53%)稳定型心绞痛患者中均未发生(P<0.001)。10年后,302例存活的稳定型心绞痛患者中有196例(65%)无症状,153例存活的不稳定型心绞痛患者中有104例(68%)无症状。

结论

PTCA后十年的随访表明,曾患有不稳定型心绞痛的患者发生心脏事件的频率明显高于稳定型心绞痛患者。这种差异在PTCA后的第一年就已出现,之后没有增加。两组患者在10年后症状均得到持久改善。

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