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Ann Intern Med:你知道预测心血管不良事件时选SPECT还是CMR吗?(CE-MARC)

2016-05-17 Seven L MedSci原创

近期发表在Ann Intern Med的CE-MARC研究结果表明,校正心血管危险因素、造影结果或初始治疗后,心血管磁共振比单光子发射CT具有更强的主要不良心血管事件预测能力。在2006年3月至2009年8月期间,研究人员随机分配752例可疑稳定型心绞痛患者进行心血管磁共振(CMR)检查,随后行SPECT检查;或者患者先行SPECT检查,随后行CMR检查。研究以主要不良心血管事件作为主要结果。随访

近期发表在Ann Intern Med的CE-MARC研究结果表明,校正心血管危险因素、造影结果或初始治疗后,心血管磁共振比单光子发射CT具有更强的主要不良心血管事件预测能力。

在2006年3月至2009年8月期间,研究人员随机分配752例可疑稳定型心绞痛患者进行心血管磁共振(CMR)检查,随后行SPECT检查;或者患者先行SPECT检查,随后行CMR检查。研究以主要不良心血管事件作为主要结果。随访时间持续约5年,最终有628名患者的数据纳入研究。

研究结果显示,整个研究人群中共有33 (4.4%)例难于对付的临床事件,最终分析的人群中该数据为25 (4%)例。研究者发现,两组的异常读数和难于对付的临床事件发生率见得相关性相似(分别为7.9%和7.4%)。此外,两组异常读数和异常读数和发生率见得相关性也相似(CMR, 25.2%; SPECT, 21.2%)。

最终分析人群中有104(16.6%)名患者至少有一个主要的不良心血管事件。无论是CMR组还是SPECT组,异常读数的HRs相似(HR = 2.77; 95% CI, 1.85-4.16 vs. HR = 1.62; 95% CI, 1.1-2.38),但是校正其他心血管危险因素、造影结果和初始治疗后,只有CMR的预测准确性仍然显著 (HR = 2.34; 95% CI, 1.51-3.63)。

研究者写道:“研究结果表明,相比于SPECT,CMR预测患者结局的效果更优;同时也为CMR在诊断和治疗可疑冠心病方面增添了证据。”

原始出处:

Greenwood JP, et al.Prognostic Value of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Suspected Coronary Heart Disease: Long-Term Follow-up of a Prospective, Diagnostic Accuracy Cohort Study.Ann Intern Med. 2016; doi:10.7326/M15-1801.

CMR more accurate than SPECT at predicting major adverse CV events
.Healio.ay 16, 2016

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    2016-06-06 feather89
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    2017-02-20 guozhenyu
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