• 作者： 宋丕錕; 謝士明; 柯國銓; 王丹江; 楊茂勳; 劉丕華
• 作者服務機構： 國防醫學院三軍總醫院內科部心臟血管科
• 中文摘要： 經心臟導管攝影證實罹患嚴重冠狀動脈病者465位，歷1至7年之追?調查，5年後之累積存活率為72％，其中僅單
  一主要冠狀動脈狹窄者之存活率為87％，兩條狹窄者73％，而三條均狹窄者51％。分組分析顯示，臨床病史中曾患心肌梗
  塞，與僅患狹心症者之間，無明顯預後差異。這或可說明冠狀動脈病之程度乃為此病預後之最重要因素。此外心電圖異
  常，鬱血性心臟衰竭，在心室收縮異常及其射出率減退等因素均為死亡率增加之重要因素。
  本報告應能提供預後冠狀動脈病及評估其選擇治療方法之參考。A
• 英文摘要： Studying the natural history of coronary artery disease could provide a frame of reference for pro-gnosis and appraisal of treatment for patients having this disease. We studied a total of 465 consecutivepatients with angiographically significant coronary artery disease, defined as > 50% stenosis in at least oneprincipal artery, who were followed with medical treatment only from 1 to 7 years. Excluding patientswith left main coronary disease, there were 73 deaths, of whom 63 were cardiac. The 5-year cumulativesurvival rates were 72% for the entire group, 87% for signle vessel disease, 73% for double vessel disease and51% for triple vessel disease. In single vessel disease, patients with left anterior descending artery involve-ment tended to have higher mortality. In double vessel disease, survival was worse with the combination ofleft anterior descending and right coronary artery involvements than the other 2 combinations. A historyof myocardial infarction was not significantly different from angina in 5-year survival rate. Nevertheless,an abnormal Q-wave in ECG was associated with lower survival. History of hypertension and electrocar-diographic left ventricular hypertrophy did not affect survival. While congestive heart failure, abnormalresting LVEDP and left ventricular asynergy were all associated with reduced survival. The left ventricularejection fraction had highly prognostic value, only 42% of patients survived with ejection fraction < 0.3at the end of 5 years after angiography.
• 中文關鍵字： coronary artery disease; coronary angiography; left ventriculography; angina pectoris; ejection fraction.
• 英文關鍵字： --