Zambanini A, French J K, Webster M W, White H D
Cardiology Department, Green Lane Hospital, Auckland, New Zealand.
J Eval Clin Pract. 1998 May;4(2):93-102.
Evidence from the randomized studies of coronary surgery suggests that patients who benefit from surgery in terms of improved survival are those with left main stem stenosis, triple vessel coronary artery disease, impaired left ventricular function or higher angina class. Patients currently undergoing surgery are in general older, with more severe angina, more comorbidity and more extensive coronary disease as compared with the population randomized in the earlier studies. Angioplasty has been shown to improve symptoms and to reduce the need for surgery in certain patients. Recent changes in procedural techniques and adjunctive therapies have reduced the number of acute complications and the rate of restenosis. However, recent evidence suggests that some patients with mild angina (< class 2) or good exercise tolerance may not benefit as much from angioplasty as other patients with more severe angina.
冠状动脉手术随机研究的证据表明，从改善生存率角度受益于手术的患者是那些患有左主干狭窄、三支冠状动脉疾病、左心室功能受损或心绞痛分级较高的患者。与早期研究中随机分组的人群相比，目前接受手术的患者总体上年龄更大，心绞痛更严重，合并症更多，冠状动脉疾病更广泛。血管成形术已被证明可改善症状并减少某些患者的手术需求。手术技术和辅助治疗的最新变化减少了急性并发症的数量和再狭窄率。然而，最近的证据表明，一些轻度心绞痛（<2级）或运动耐量良好的患者可能不如其他心绞痛更严重的患者从血管成形术中获益那么多。
