The prognostic significance of the anoxemia test in coronary heart disease. A follow-up study of 254 subjects

1. 1. In order to appraise the prognostic value of the anoxemia test, a follow-up study was made of 254 individuals on whom it was performed during the decade 1937 to 1947. Included were 141 patients with manifest or suspected coronary heart disease, ten with hypertension, and 103 with no evidence of a cardiovascular disorder. The average follow-up period was six years. 2. 2. Sixty-three individuals died during the course of the study. In the sixteen cases in which an autopsy was performed, the clinical diagnosis was confirmed. 3. 3. The material was analyzed by statistical methods in an effort to find correlations between the result of the anoxemia test, the clinical status, and the prognosis. The results were inconclusive. 4. 4. A comparison of the cumulative mortality rates of the patients with coronary sclerosis and anginal pain and the noncardiac subjects, grouped according to the result of the initial anoxemia test, showed distinct differences. In the coronary patients whose tests were positive, the prognosis was significantly worse, with respect to longevity, than in those whose tests were negative. It should be emphasized, however, that, whereas this obtains for the group as a whole, it does not necessarily apply to any individual patient. 5. 5. The anoxemia test furnishes an index of the coronary reserve only at the time of its performance. Because of the numerous uncontrollable variables affecting the lesions of atherosclerosis, it is not possible to predict accurately, within a wide range of probability, the future clinical course of the patient with coronary heart disease.