Cleland J G
CRI in Heart Failure, University of Glasgow, U.K.
Eur Heart J. 1996 Mar;17 Suppl A:29-40. doi: 10.1093/eurheartj/17.suppl_a.29.
Angina pectoris is a common symptom in patients over 50 years and is usually secondary to myocardial ischaemia resulting from coronary artery disease. The management of angina should be aimed at the maintenance or improvement of quality of life and delaying death. There are three strategies that may be adopted: medical, percutaneous transluminal coronary angioplasty and surgery. The majority of patients with angina can be controlled symptomatically most of the time by medical treatment alone. Any assessment of cost of treatment must take into account the cost of investigation, treatment, the morbidity associated with procedures or side effects of drugs, together with that of recurrent hospitalization, prolonged life and premature death. In addition, the duration of treatment has a major bearing on cost. Taking these factors into account, medical therapy is the least expensive short- and long-term treatment for angina pectoris. A medical approach to treatment also has considerable advantages over an interventional approach in terms of major morbidity. Only one of six surgical trials has demonstrated a survival benefit.
心绞痛是50岁以上患者的常见症状，通常继发于冠状动脉疾病导致的心肌缺血。心绞痛的治疗应旨在维持或改善生活质量并延缓死亡。可采用三种策略：药物治疗、经皮冠状动脉腔内血管成形术和手术治疗。大多数心绞痛患者大部分时间仅通过药物治疗就能症状性地得到控制。任何治疗费用评估都必须考虑检查费用、治疗费用、与手术相关的发病率或药物副作用，以及再次住院、延长生命和过早死亡的费用。此外，治疗持续时间对费用有重大影响。考虑到这些因素，药物治疗是心绞痛短期和长期治疗中最便宜的方法。在主要发病率方面，药物治疗方法也比介入治疗方法具有相当大的优势。六项手术试验中只有一项显示出生存获益。
