在ISCHEMIA试验中的心肌梗塞:不同定义对发病率,预后和治疗比较的影响
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在PubMed上查看摘要
概括
此摘要是机器生成的。在ISCHEMIA试验中,保守的策略导致了更多的1型心肌梗塞 (MI),但没有增加心血管死亡. 侵袭性策略导致了更多的程序性MI,特别是基于热的敏感定义.
科学领域
- 心脏病学
- 临床试验
- 缺血性心脏病
背景情况
- 在ISCHEMIA试验中,对稳定性缺血性心脏病进行了入侵与保守策略的评估.
- 心肌梗塞 (MI) 是复合心血管终点的常见组成部分.
研究的目的
- 根据治疗指定的MI类型,频率和预后 (侵袭性与保守性) 和MI定义进行比较.
- 分析不同MI定义对试验结果的影响.
主要方法
- ISCHEMIA使用了两个MI定义:初级 (肌酸激酶- MB) 和二级 (心脏热素).
- 程序性MI定义包括高生物标志物,ST段抑郁和冠状动脉剖析.
- 侵袭性和保守性策略之间的MI率和结果比较.
主要成果
- 在侵袭性策略中,手术性心脏病发作更频繁,特别是使用二次热素定义 (8. 2% 与2. 0% 相比).
- 侵袭策略的1型心脏病发作频率较低 (3. 4% vs 6. 9%),并与较高的心血管死亡风险相关.
- 二次性MI定义发现了比主要定义更多的程序性MI.
结论
- 使用保守策略时,1型心脏病发作更频繁,并与随后的心血管死亡有关.
- 受使用的MI定义的影响,手术性MI的发病率较高.
- 选择MI定义对程序性MI和整体试验结果的评估有重大影响.
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