Bertolasi C A, Tronge J E, Riccitelli M A, Villamayor R M, Zuffardi E
Chest. 1976 Nov;70(5):596-605. doi: 10.1378/chest.70.5.596.
In order to establish the natural evolution of unstable angina under medical treatment and to determine the possible benefits of revascularization surgery, 113 patients were studied; 51 received medical treatment (24 with intermediate syndrome and 27 with progressive angina), and 62 others received surgical treatment (28 with intermediate syndrome and 34 with progressive angina). After a mean follow-up of 32 months, the mortality in the medically treated groups was 46 percent (11/24) with intermediate syndrome and 7 percent (2/27) with progressive angina (P less than 0.005), and the incidence of myocardial infarction was 38 percent (9/24) and 7 percent (2/27), respectively (P less than 0.01). Moreover, in comparing cases treated medically or surgically, the mortality was as follows: intermediate syndrome treated medically, 46 percent (11/24) vs 11 percent (3/28) in those treated surgically (P less than 0.005); and progressive angina treated medically, 7 percent (2/27) vs 9 percent (3/34) in those treated surgically (P = 0.85). The incidence of myocardial infarction was as follows: intermediate syndrome treated medically, 38 percent (9/24) vs 14 percent (4/28) in those treated surgically (P less than or equal to 0.056); and progressive angina treated medically, 7 percent (2/27) vs 12 percent (4/34) in those treated surgically (P greater than 0.55).
为了确定不稳定型心绞痛在药物治疗下的自然转归，并确定血运重建手术可能带来的益处，对113例患者进行了研究；51例接受药物治疗（24例为中间综合征，27例为进行性心绞痛），另外62例接受手术治疗（28例为中间综合征，34例为进行性心绞痛）。平均随访32个月后，药物治疗组中，中间综合征患者的死亡率为46%（11/24），进行性心绞痛患者的死亡率为7%（2/27）（P<0.005），心肌梗死发生率分别为38%（9/24）和7%（2/27）（P<0.01）。此外，比较药物治疗和手术治疗的病例，死亡率如下：药物治疗的中间综合征患者为46%（11/24），手术治疗的患者为11%（3/28）（P<0.005）；药物治疗的进行性心绞痛患者为7%（2/27），手术治疗的患者为9%（3/34）（P=0.85）。心肌梗死发生率如下：药物治疗的中间综合征患者为38%（9/24），手术治疗的患者为14%（4/28）（P≤0.056）；药物治疗的进行性心绞痛患者为7%（2/27），手术治疗的患者为12%（4/34）（P>0.55）。
