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The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel
Chenfei Rao1, Tasce Bongiovanni2, Xi Li1
1National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Insights
This study investigates treatment strategies and outcomes for complex coronary artery disease in China. It aims to improve care for patients with three-vessel disease and left main disease.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Services Research
Background:
- Complex coronary artery disease (left main and three-vessel disease) presents significant risks and costs.
- Current treatment strategies and outcomes in China for these complex cases are not well understood.
Purpose of the Study:
- To describe treatment strategies for complex coronary artery disease in China.
- To evaluate guideline adherence and patient outcomes.
- To identify factors influencing treatment decisions and improve quality of care.
Main Methods:
- Prospective cohort study of over 4000 patients with three-vessel disease or left main disease across 24 centers in China.
- Centralized medical record abstraction and SYNTAX score calculation.
- 1-year follow-up on major adverse cardiac events, symptoms, and quality of life.
Main Results:
- Analysis of patient, clinician, and hospital factors associated with treatment choices (PCI, CABG, medical therapy).
- Assessment of treatment appropriateness and guideline compliance.
- Evaluation of patient-reported outcomes.
Conclusions:
- Findings will inform quality improvement initiatives for complex coronary artery disease management in China.
- Promote efficient allocation and use of coronary revascularization procedures.
- Enhance knowledge on treatment patterns and outcomes in Chinese cardiovascular centers.
Introduction:
Complex coronary artery disease (left main and three-vessel disease) carries high risks of adverse events and cost burden. However, in China, little is known about which patients are directed toward which treatment strategies and what outcomes are being achieved.
Methods And Analysis:
Using the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, this prospective study of three-Vessel Disease, the China PEACE-3VD study, has a plan to consecutively register over 4000 patients with a diagnosis of 3VD and/or left-main disease by elective coronary angiography at 24 large cardiovascular centres in China. We centrally conducted medical record abstraction and SYNTAX Score calculation for all registered patients. The sites invited patients to the prospective cohort, and conducted 1-year follow-up on major events, including cardiac events, symptoms, secondary prevention and quality of life. The estimated entire sample size of eligible patients of 4000 was determined based on both feasibility and consideration of adequate statistical precision for describing the treatment decisions, guidelines adherence and appropriateness of treatment for patients with complex coronary artery diseases. The study is designed to investigate patient, clinician and hospital factors associated with each treatment strategy (percutaneous coronary intervention, coronary artery bypass grafting or medical therapy) as well as appropriateness of treatment choice, current guideline compliance and patient-reported outcomes for patients with complex coronary artery disease in large cardiovascular centres in China, as a foundation for enhanced knowledge in the field and to assist quality improvement initiatives.
Ethics And Dissemination:
The study protocol was approved by the ethics committee at the China National Center for Cardiovascular Diseases. Findings will be shared with participating hospitals, policymakers and the academic community, to promote quality monitoring, quality improvement and the efficient allocation, and use of coronary revascularisation procedures in China.
Trial Registration Number:
NCT01625312; Pre-results.
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