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Eur Heart J:计算机断层扫描冠状动脉造影获得的血流储备分数在稳定型胸痛评估中的价值

2021-07-19 MedSci原创 MedSci原创

对于稳定型心绞痛患者进行选择性FFRCT获得CTCA的策略在成本或临床结局方面与标准临床处理途径没有显著差异,但确实减少了有创冠状动脉造影的使用程度。

使用计算机断层扫描冠状动脉造影 (CTCA) 获得的血流储备分数 (FFRCT) 可确定冠状动脉疾病和血管特异性缺血。

近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员评估了基于FFRCT的评估策略与标准处理相比是否会改善经济和临床结局。

总体而言,11个中心的1400名稳定型胸痛患者随机接受CTCA和选择性FFRCT实验组)或标准临床处理途径(标准组)。该研究的主要终点是9个月时的心脏总费用;次要终点是心绞痛状态、生活质量、主要不良心脑血管事件以及有创冠状动脉造影的使用情况。

随机分组的患者在基线时相似。大多数患者进行了CTCA检查:标准组439例(63%)与实验组674例(96%),其中 254例(38%) 接受了FFRCT检查。实验组的平均心脏总费用高出114英镑(+8%),95%置信区间从-112(-8%)到+337(+23%),但差异不显著(P=0.10)。主要不良心脏和脑血管事件没有显著差异(实验组为10.2%,标准组为10.6%),并且两个组的心绞痛和生活质量在随访期间的改善程度相似。实验组有创血管造影显著减少(19% vs. 25%,P=0.01)。

由此可见,对于稳定型心绞痛患者进行选择性FFRCT获得CTCA的策略在成本或临床结局方面与标准临床处理途径没有显著差异,但确实减少了有创冠状动脉造影的使用程度。

原始出处:

N Curzen.et al.Fractional flow reserve derived from computed tomography coronary angiography in the assessment and management of stable chest pain: the FORECAST randomized trial.European Heart Journal.2021.https://doi.org/10.1093/eurheartj/ehab444

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    2022-04-22 bioon14
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    2021-07-21 zhaojie88
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    2021-07-21 sodoo
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