年龄和计算机断层扫描和侵袭性冠状动脉血管学在稳定的胸痛:一个预规定的二次分析的DISCHARGE随机临床试验
, Maria Bosserdt1, Lina M Serna-Higuita2
1Department of Radiology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
在接受计算机断层扫描 (CT) 或侵入性冠状动脉血管扫描 (ICA) 的患者中,年龄没有影响主要的不良心血管事件 (MACE). 然而,CT与年轻患者的并发症较少有关.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 临床试验 临床试验
背景情况:
- 计算机断层扫描 (CT) 和侵入性冠状动脉血管扫描 (ICA) 在不同年龄人口群体中的比较有效性和安全性仍然不清楚.
- 稳定的胸痛患者中等冠状动脉疾病风险需要评估诊断策略.
研究的目的:
- 为了研究患者年龄和CT和ICA后的结果之间的关联,在患有稳定的胸痛的人中.
- 分析年龄如何影响CT-first与直接到ICA策略的有效性和安全性.
主要方法:
- 对于患有稳定胸痛和冠状动脉疾病中间风险的患者的诊断成像策略 (DISCHARGE) 试验随机分配了3561名患者到CT-first或直接到ICA.
- 治疗意图分析检查了主要心血管不良事件 (MACE) 和与程序相关的并发症,平均随访时间为3.5年.
- 用多变量建模分析数据,将年龄视为连续变量和随机化组的相互作用.
主要成果:
- 年龄没有显著改变随机化策略对MACE的影响 (HR,1.02;P相互作用=.31).
- 年龄显著改变了随机化策略对重大手术相关并发症的影响 (OR,1.15;P相互作用=.005).
- 较年轻的患者 (65岁以下) 与CT-first策略相比,在CT-first策略中经历的重大程序相关并发症较少.
结论:
- 年龄不会改变CT或ICA对稳定的胸痛患者主要心血管不良事件的影响.
- 计算机断层扫描 (CT) 与侵袭性冠状动脉血管学 (ICA) 相比,对于年轻患者的手术相关并发症来说似乎更安全.
- 这些发现支持基于年龄和风险概况的个性化诊断方法.
更多相关视频
04:40Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
相关概念视频
Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
Radiological Investigation I: X-ray and CT
