在日常实践中符合COAPT试验的资格:现实世界的经验
Edoardo Zancanaro1, Nicola Buzzatti1, Paolo Denti1
1Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
概括
只有14%的功能性额头肌吐 (FMR) 患者满足了COAPT试验的标准. 然而,MitraClip治疗改善了非COAPT符合条件的患者的生存率,这表明过导管美肌修复的应用范围更广.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏门疾病 心脏门疾病
背景情况:
- 在COAPT试验中,在选择的功能性额头吐 (FMR) 患者中,通过导管额头修复的生存益处被确定.
- 在现实世界中,COAPT选择标准的适用性仍然不清楚.
研究的目的:
- 在现实环境中评估符合COAPT标准的FMR患者的比例.
- 评估COAPT标准对患者生存结果的影响.
主要方法:
- 在第三级医院对连续的FMR患者 (2016年1月至2021年5月) 的回顾性分析.
- 由心脏外科医生和心脏病学家对COAPT资格的评估.
- 在接受MitraClip的患者和接受优化医疗治疗的患者之间生存率的比较.
主要成果:
- 在转诊的FMR患者中,只有14% (56名394名) 符合COAPT资格标准.
- 常见的排除原因包括轻度/中度反,异常的喷射分数和非优化的指导方针导向医学治疗.
- 在非COAPT符合条件的患者中,那些接受MitraClip治疗的人与单独优化医疗治疗 (71.8%) 相比,显示了显著更高的加权4年生存率 (91.5%).
结论:
- 一小部分现实 FMR 患者符合严格的 COAPT 试验选择标准.
- 通过MitraClip进行过导管美特拉修复,即使在不符合COAPT标准的FMR患者中,也可能带来生存益处,这表明治疗潜力扩大.
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