连续冠状动脉图的变化和随后的冠状动脉事件. 超脂血症 (POSCH) 组的手术控制
H Buchwald1, J P Matts, L L Fitch
1Department of Surgery, University of Minnesota, Minneapolis 55455.
JAMA
|September 16, 1992
概括
连续的冠状动脉图变化预测临床事件,为患者的整体和动脉样硬化冠状动脉心脏病死亡率提供预后指标. 这有助于动脉样硬化干预试验.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 干预心脏病学 干预心脏病学
背景情况:
- 动脉样硬化干预试验需要可靠的结果测量.
- 连续冠状动脉图提供了有关疾病进展的详细见解.
研究的目的:
- 评估连续冠状动脉图的变化与随后的临床冠状动脉事件之间的关系.
- 确定动脉图变化是否可以作为动脉样硬化试验中的替代终点.
主要方法:
- 一项随机试验 (超脂血症手术控制计划) 涉及838名患者.
- 冠状动脉图在基线,3年,5年,7年/10年获得.
- 对动脉图学变化和与临床事件的相关性进行盲目评估.
主要成果:
- 冠状动脉图的变化显著预测了整体和动脉样硬化冠状动脉心脏病死亡率.
- 在对照组和手术组中,动脉图学变化与死亡率或心肌梗塞的结合终点之间发现了强烈的关联.
- 分层分析显示了基于疾病进展的临床事件的显著差异.
结论:
- 冠状动脉变化是动脉样硬化试验中特定临床事件的有效代用终点.
- 动脉图评估为预测死亡率提供了统计学上令人信服的证据.
- 冠状动脉样硬化严重程度的变化是个别患者的预后指标.
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