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【文摘发布】心肌梗死后无症状性心肌缺血应用
Author：Paul Erne, MD; Andreas W. Schoenenberger, MD; Dieter Burckhardt, MD;et al
Resource:JAMA. 2007;297:1985-1991.
Abstract：Context :The effect of a percutaneous coronary intervention (PCI) on the long-term prognosis of patients with silent ischemia after a myocardial infarction (MI) is not known.
Objective : To determine whether PCI compared with drug therapy improves long-term outcome of asymptomatic patients with silent ischemia after an MI.
Design, Setting, and Participants: Randomized, unblinded, controlled trial (Swiss Interventional Study on Silent Ischemia Type II [SWISSI II]) conducted from May 2, 1991, to February 25, 1997, at 3 public hospitals in Switzerland of 201 patients with a recent MI, silent myocardial ischemia verified by stress imaging, and 1- or 2-vessel coronary artery disease. Follow-up ended on May 23, 2006.
Interventions: Percutaneous coronary intervention aimed at full revascularization (n = 96) or intensive anti-ischemic drug therapy (n = 105). All patients received 100 mg/d of aspirin and a statin.
Main Outcome Measures : Survival free of major adverse cardiac events defined as cardiac death, nonfatal MI, and/or symptom-driven revascularization. Secondary measures included exercise-induced ischemia and resting left ventricular ejection fraction during follow-up.
Results : During a mean (SD) follow-up of 10.2 (2.6) years, 27 major adverse cardiac events occurred in the PCI group and 67 events occurred in the anti-ischemic drug therapy group (adjusted hazard ratio, 0.33; 95% confidence interval, 0.20-0.55; P<.001), which corresponds to an absolute event reduction of 6.3% per year (95% confidence interval, 3.7%-8.9%; P<.001). Patients in the PCI group had lower rates of ischemia (11.6% vs 28.9% in patients in the drug therapy group at final follow-up; P = .03) despite fewer drugs. Left ventricular ejection fraction remained preserved in PCI patients (mean [SD] of 53.9% [9.9%] at baseline to 55.6% [8.1%] at final follow-up) and decreased significantly (P<.001) in drug therapy patients (mean [SD] of 59.7% [11.8%] at baseline to 48.8% [7.9%] at final follow-up).
Conclusion: Among patients with recent MI, silent myocardial ischemia verified by stress imaging, and 1- or 2-vessel coronary artery disease, PCI compared with anti-ischemic drug therapy reduced the long-term risk of major cardiac events.
Trial Registration clinicaltrials.gov Identifier: NCT00387231 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title：Effects of Percutaneous Coronary Interventions in Silent Ischemia After Myocardial Infarction：The SWISSI II Randomized Controlled Trial
题目：心肌梗死后无症状性心肌缺血应用经皮冠状动脉介入有益 罗战友总体译的相当好，提几点小问题：
1.目的中“提高...预后”改为“改善...预后”是否更好；
2.Main Outcome Measures 译为：主要测量指标；
3.cardiac death译为：心源性死亡；
4.Secondary measures译为：次要测量指标；
5.mean (SD) follow-up of 10.2 (2.6) years译为：在平均10.2±2.6年的随访期内；mean 为平均的意思，中位应为median，如果用中位数表示的话就不会出现SD了；后同；
6.“调整后HR＝0.33”改为“校正后的HR”；
7.“减低了长期主要心脏意外的危险”改为“降低了长期主要心脏事件的风险”。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-02-27 17:12
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