胸の痛みに対する非侵襲的イメージングのランダム化試験における高齢者および女性の代表
Phillip Lim1, Tansu Eris1, Leslee J Shaw1,2
1Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY. (P.L., T.E., L.J.S., F.A.L., D.L.B., G.S., K.K.P.).
Circulation. Cardiovascular imaging
|September 3, 2025
まとめ
高齢者,特に75歳以上の成人は,不全性心疾患の非侵襲的な画像検査で不足しています. 女性の割合は十分であるが,一般化可能な結果を得るためには,将来の研究で高齢者を多く含めなければならない.
科学分野:
- 心臓病科
- 医療用イメージング
- 臨床試験
背景:
- 非侵襲的イメージングは 発血性心臓病の診断と管理に不可欠です
- 高齢者および女性は治療に異なる反応を示し,結果も異なることがあります.
- 臨床試験における 人口分布を理解することは 公平な医療に不可欠です
研究 の 目的:
- 発血性心臓病の非侵襲的画像検査におけるランダム化制御試験 (RCT) の高齢者および女性の割合を評価する.
- 胸痛試験における異なる年齢層と女性の参加率 (PPR) を分析する.
- 脆弱な集団の試験登録における潜在的な格差を特定する.
主な方法:
- PubMed,ClinicalTrials.gov,RCTのガイドライン (2002年から2023年) の体系的な検索
- 急性および安定した胸痛に対する非侵襲的イメージングに関する試験を含む.
- 女性と年齢サブグループ (<65,65-74,75歳) のPPRの計算
主要な成果:
- 年齢 (21 件の試験,n=35,503) と性別 (53 件の試験,n=55,893) のデータを基にした53件のRCTの分析.
- 65歳未満の参加者の割合は過剰でした (PPR=2.13).
- 高齢者 (65~74歳,PPR=0. 74; ≥75歳,PPR=0. 21) が不足していた.
- 女性の割合は十分であった (PPR=1.2).
結論:
- 女性の割合は不全性心疾患のイメージング試験に適している.
- 65歳以上,特に75歳以上の成人の割合はかなり低い.
- 将来のRCTは高齢者を優先して参加し,結果がこの集団に一般化できるようにしなければなりません.
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