不安定な胸痛に対する心筋膜再血管化は,
G C Kaiser1, H V Schaff, T Killip
1Department of Surgery, St. Louis University, Missouri.
Circulation
|June 1, 1989
まとめ
不安定性胸痛に対する冠動脈バイパス移植 (CABG) は,安定性胸痛と同様の結果を示しますが,リスクを減らすためにより良い手術前管理と心筋保存が必要です.
科学分野:
- 心臓病学 心臓病学
- 心臓外科手術について
- 血管外科 血管外科
背景:
- 不安定なアンギナ・ペクトリスは,心臓外科手術において重要な課題を提示します.
- 冠動脈バイパス移植 (CABG) は,主要な治療方法である.
- 結果とリスク要因は,詳細な分析を必要とする.
研究 の 目的:
- CABGの有効性と安全性を評価するために,不安定な胸の痛みを持つ患者で.
- 罹病率と死亡率に関連する危険因子を特定する.
- 結末を慢性的な安定性 angina の患者の結末と比較する.
主な方法:
- 1978年から1988年の間に発表された14の報告書の体系的なレビュー.
- 不安定性アンギナ・ペクトリスのためにCABGを受けた6,136人の患者を含めた.
- 術後の死亡率,術後の心筋梗塞,術後の低心電量に関する分析.
主要な成果:
- 平均手術後の死亡率は3.7%,手術後の心筋梗塞は9.9%,低心電量16%でした.
- 慢性的な安定性アンギナと比較して,発症率や死亡率に関する明確なリスク要因は特定されなかった.
- アンギナ緩和,生存,および遅発性心筋梗塞を含むアウトカムは,慢性的な安定したアンギナと比較可能でした.
結論:
- CABGは,安定したアングイナと不安定なアングイナに対して,比較可能な利点を提供しています.
- サブグループ分析は,不安定なアンギナの中で様々な予後を明らかにします.
- 術前管理の改善と心筋膜の保存は,CABGに関連する合併症の軽減に不可欠です.
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