患有心力衰竭或左心室功能障碍的患者稳定性缺血性心脏病的初始侵入性与保守性治疗:ISCHEMIA试验的见解
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在PubMed上查看摘要
概括
此摘要是机器生成的。对于患有稳定性缺血性心脏病和心力衰竭 (HF) 或左心室功能障碍 (LVD) 的患者,初步的侵入性策略可能会改善结果,特别是在减少排泄率 (EF) 的患者中. 这种方法在高风险小组中显示出更好的无事件生存率,HF和EF为35%至45%.
科学领域
- 心脏病学
- 干预心脏病学
- 心脏衰竭的治疗方法
背景情况
- 稳定性缺血性心脏病 (SIHD) 患者中度缺血和心力衰竭 (HF) 或左心室功能障碍 (LVD) 是一个复杂的子组.
- 对SIHD患者的最佳治疗策略 (侵入性或保守性) 仍然不清楚,HF/ LVD和保存的射出分数 (EF) ≥35%.
研究的目的
- 调查最初的侵入性策略是否改善SIHD中度性缺血和HF/ LVD病史患者的心血管结果.
- 根据HF/LVD的存在和严重程度,比较入侵和保守策略之间的结果.
主要方法
- 来自ISCHEMIA试验的数据分析,随机分配5179名LVEF≥35%的SIHD患者进行侵入性或保守的治疗策略.
- 具有HF/LVD病史和没有HF/LVD病史的参与者之间心血管结果的比较,并按LVEF分层.
主要成果
- 与没有HF/ LVD的患者相比,HF/ LVD患者的共发病率较高,主要综合结局 (心血管死亡,心脏病发作或特定住院) 较多.
- 在HF/ LVD小组中,与保守策略相比,侵入性策略的初级结局率较低 (17.2%对29. 3%).
- 一个小的,高风险的小组,HF和LVEF的35%-45%,在最初的侵入性治疗中表现出更好的无事件生存率.
结论
- 患有中度缺血症和HF/ LVD病史的SIHD患者患有心血管不良事件的风险增加.
- 对于高风险的HF/ LVD患者,特别是那些LVEF为35% - 45%的患者,初步的侵入性策略可能是有益的,因此需要进一步调查.
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