Ishiguro T, Seki M, Gyouda Y, Yamauchi A, Yokota M
Department of Anesthesiology, Nikon University School of Medicine, Tokyo.
Masui. 1998 Mar;47(3):269-76.
Coronary risk index (CRI) is our newly developed screening method for ischemic heart disease in preoperative evaluation. In this study, we assessed the practicability of CRI examining coronary angiograms (CAG) obtained in 106 patients scheduled for operations. CAG was rated with CAG score, then CRI and CAG score were statistically analyzed. These two parameters showed a significant positive relationship; the higher CRI, the higher CAG score (P < 0.0001). When the patients were divided into five groups by their CRI (0-9, 10-14, 15-19, 20-24, and more than 25), the group with higher CRI contained significantly more patients with severe multivessel coronary lesion (P < 0.0001). Similar results were obtained even in the patient with minimal change in ECG or exercise ECG, or those with minimal chest symptoms (P < 0.001). These results suggests that CRI works effectively as a screening method for ischemic heart disease regardless of abnormalities in ECG or the chest symptoms. More cautious perioperative management should be carried out in patients with higher CRI.
冠状动脉风险指数(CRI)是我们新开发的用于术前评估缺血性心脏病的筛查方法。在本研究中,我们评估了CRI用于检查106例计划手术患者的冠状动脉造影(CAG)的实用性。CAG用CAG评分进行评级,然后对CRI和CAG评分进行统计学分析。这两个参数显示出显著的正相关关系;CRI越高,CAG评分越高(P < 0.0001)。当根据CRI将患者分为五组(0 - 9、10 - 14、15 - 19、20 - 24以及超过25)时,CRI较高的组中患有严重多支冠状动脉病变的患者明显更多(P < 0.0001)。即使在心电图或运动心电图变化极小或胸部症状轻微的患者中也得到了类似结果(P < 0.001)。这些结果表明,无论心电图或胸部症状是否异常,CRI作为缺血性心脏病的筛查方法都能有效发挥作用。对于CRI较高的患者,应进行更谨慎的围手术期管理。