现场计算机断层扫描衍生分流储备以指导稳定冠状动脉疾病患者的管理:TARGET随机试验
Junjie Yang1, Dongkai Shan1, Xi Wang1
1Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing (J.Y., D.S., X.W., Z.L., Y.C.).
Circulation
|March 4, 2023
概括
在现场计算断层扫描衍生分流储备 (CT-FFR) 减少了稳定冠状动脉疾病的不必要的侵入性手术. 然而,与标准治疗相比,它没有改善临床结果或生活质量.
科学领域:
- 心脏病学
- 医学成像
- 医学的人工智能
背景情况:
- 计算机断层扫描衍生分流储备 (CT-FFR) 有助于识别冠状动脉疾病和缺血.
- 与标准治疗相比,现场CT-FFR对稳定的冠状动脉疾病患者的临床和经济影响尚不清楚.
研究的目的:
- 通过机器学习评估现场CT-FFR护理途径在稳定冠状动脉疾病患者中的有效性.
- 将CT-FFR途径与标准护理之间的临床和经济结果进行比较.
主要方法:
- 这是一项随机试验,涉及1216名冠状动脉疾病和中间狭窄症患者.
- 患者被分配到现场CT-FFR途径或标准治疗.
- 主要终点:在90天内接受不必要的侵袭性冠状动脉造影的患者比例.
主要成果:
- 在CT-FFR组中,不必要的侵袭性冠状动脉血管检查的患者比例显著降低 (28. 3% vs 46. 2%).
- 在CT-FFR组中,复血管化率较高 (49.7%对42. 8%).
- 在1年内,主要心血管不良事件,生活质量或心痛症状没有显著差异.
结论:
- 在现场CT-FFR减少了不必要的侵入性手术,但增加了整体的再血管化.
- 在CT-FFR途径中,主要心血管不良事件,症状或生活质量没有得到改善.
- 在CT-FFR组中观察到医疗费用下降的趋势.
相关概念视频
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
53
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
53
Imaging Studies for Cardiovascular System V: CT
56
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
56
Acute Coronary Syndrome III: Diagnostic Studies
19
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
19


