对多血管或左主冠状动脉疾病患者进行皮肤干预后的监测压力测试
Joong Min Lee1, Hoyun Kim1, Young-Sun Park1
1Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Journal of the American College of Cardiology
|February 28, 2024
概括
穿皮冠状动脉干预 (PCI) 后的常规功能测试对于患有多血管或左主冠状动脉疾病 (CAD) 的高风险患者没有额外的好处. 这种方法并没有改善结果,而是增加了侵入性手术.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床试验 临床试验
背景情况:
- 对于患有多血管或左主冠状动脉疾病 (CAD) 的高风险患者,穿皮冠状动脉干预 (PCI) 后的最佳监测尚未明确.
- 目前的指导方针缺乏关于在这种患者群体中进行常规功能测试与标准护理的共识.
研究的目的:
- 评估PCI后多血管或左主CAD的高风险患者的常规功能测试的预后价值.
- 为了比较常规功能测试的临床结果与随访期间的标准护理.
主要方法:
- 在高风险患者接受皮肤冠状动脉干预 (POST-PCI) 试验中,实用试验比较了以症状为导向的与例行压力测试的患者.
- 高风险的PCI患者被分配到1年后的常规功能测试或标准护理.
- 主要结局是所有死因,心肌梗塞或不稳定的心痛入院2年后的综合结合.
主要成果:
- 在1,192名多血管或左主CAD患者中,常规功能测试 (6.2%) 和标准护理 (5.7%) 组之间的2年初级结局率相似 (HR:1.09;P=0.73).
- 在多血管 (6.2%对5.7%) 或左主疾病 (6.2%对5.7%) 分组中没有发现显著差异.
- 常规检测导致侵袭性血管造影和重复血管化率增加超过1年.
结论:
- 与标准护理相比,常规监测功能测试对于PCI后多血管或左主CAD的高风险患者没有增加的临床益处.
- POST-PCI试验表明,以症状为导向的随访可能足够,避免不必要的侵入性手术.
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