Ike S, Maruyama A, Morita T, Hirooka K, Chin W, Asao M, Hayashi T, Inoue M
Division of Cardiovascular Diseases, Osaka National Hospital.
J Cardiol. 1998 Nov;32(5):301-6.
The appearance of a new coronary artery lesion is important in patients with acute myocardial infarction or late coronary artery bypass grafting surgery, which sometimes lead to cardiac death. We studied coronary angiograms of 1,098 patients with coronary artery disease (from 1985 to 1996) and found new lesions in 94 patients (male 74, female 20; mean age 61.6 years). Mean observation period of all 1,098 patients was 50.1 +/- 30.4 months, and that of patients with new lesions was 73.2 +/- 31.2 months. Clinical findings of the 94 patients were acute myocardial infarction (n = 28), recurrent angina (n = 56), and silent ischemia (n = 10). The appearance of a new coronary lesion was found in 2.4% (1992), 1.9% (1993), 2.3% (1994), 1.7% (1995) of all patients with ischemic heart disease per year. The new lesions were found more often in patients with non-significant stenotic lesions (n = 74) than in patients with lesions of > or = 50% stenosis (n = 20). Complex lesions were found in 56% of the recurrent angina group, and in 22% of the silent ischemia group. In our study, the rate of appearance of new coronary artery lesions was much lower than in Europe or the United States of America. These results require careful consideration for coronary revascularization procedures in Japanese patients.
新发冠状动脉病变的出现对于急性心肌梗死患者或晚期冠状动脉搭桥手术患者而言至关重要，这有时会导致心源性死亡。我们研究了1985年至1996年间1098例冠心病患者的冠状动脉血管造影，发现94例患者（男性74例，女性20例；平均年龄61.6岁）有新发病变。所有1098例患者的平均观察期为50.1±30.4个月，有新发病变患者的平均观察期为73.2±31.2个月。这94例患者的临床表现为急性心肌梗死（28例）、复发性心绞痛（56例）和无症状性缺血（10例）。每年在所有缺血性心脏病患者中，新发冠状动脉病变的出现率分别为2.4%（1992年）、1.9%（1993年）、2.3%（1994年）、1.7%（1995年）。新发病变在非显著性狭窄病变患者（74例）中比在狭窄≥50%病变患者（20例）中更常见。复发性心绞痛组中56%发现有复杂病变，无症状性缺血组中22%发现有复杂病变。在我们的研究中，新发冠状动脉病变的发生率远低于欧洲或美国。这些结果对于日本患者冠状动脉血运重建手术的考量需要谨慎。
