自动冠状动脉CT衍生的分数流量储备的临床有效性:中国一项随机对照试验
Bangjun Guo1, Wei Xing1, Chunhong Hu1
1From the Departments of Radiology (B.G., J. Zhong, C.S.Z., F.Z., C.Y.L., X.L.Z., P.P.X., C.X.T., G.M.L., L.J.Z.), Cardiology (J.H.L.), and Critical Care Medicine (Y.X.L.), Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Eastern Zhongshan Rd, Nanjing 210002, China; Department of Radiology, the Third Affiliated Hospital of Soochow University, Soochow University, Changzhou, China (W.X., Jinggang Zhang); Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, China (C.H., M.C.); Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China (Y. Zha, B.X.); Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (X.Y., Q.C.); Department of Radiology, People's Hospital of Maanshan, Maanshan, China (Y.H., W.D.); Department of Medical Imaging, the Affiliated Hospital of Jiangnan University, Wuxi, China (S.H., H.Q.); Department of Diagnostic Radiology, Xuzhou Central Hospital, Xuzhou, China (Y.S., Y. Zhang); Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China (F.L., R.X.); Department of Medical Imaging, Guizhou Province People's Hospital, Guiyang, China (R.W., X. Liu); Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China (X. Li); Medical Imaging Center, Affiliated Hospital of Nantong University, Nantong, China (H.G., S.M.T.); Department of Radiology, the First People's Hospital of Xuzhou, Xuzhou, China (W.C., T.Z.); Department of Medical Imaging, Jiangyin People's Hospital, Jiangyin, China (Jinhua Zhang, C.Q.Y.); Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (Y. Zhou, W.L.); Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China (Y.X., M.Z.); Department of Radiology, the Affiliated Hospital of Jining Medical University, Jining, China (M.C.J., Y.C.); Shukun (Shanghai) Technology, Shanghai, China (W.Z.); School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.J.L.); and Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China (Y.W.).
在冠状动脉CT血管造影 (CCTA) 中添加冠状动脉CT衍生分流储备 (CT-FFR) 后,90天内侵袭性冠状动脉血管造影 (ICA) 的使用量减少了2.4%. 这种策略显示了类似的1年主要不良心血管事件 (MACE) 发生率,但心脏事件较少.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 冠状动脉CT衍生分流储备 (CT-FFR) 用于怀疑冠状动脉疾病 (CAD).
- 关于CT-FFR对侵袭性冠状动脉血管学 (ICA) 率和患者预后的影响的证据有限.
- 该研究涉及CT-FFR在中国临床环境中的有效性.
研究的目的:
- 评估CT-FFR添加到冠状动脉CT血管造影 (CCTA) 的效果,以减少短期ICA病例.
- 评估这种综合策略对90天和1年的重大心血管不良事件 (MACE) 的影响.
- 探索CT-FFR在指导患者管理中的预后价值.
主要方法:
- 一个多中心随机对照试验,涉及5297名25-99%冠状动脉狭窄的患者.
- 患者被随机分配到CCTA加自动CT-FFR或单独使用CCTA.
- 主要终点是90天ICA率;次要终点包括90天和1年的MACE和心脏事件.
主要成果:
- CCTA加CT-FFR组的90天ICA率显著较低 (10.0%与12.4%,P=.006).
- 两组之间90天或1年的MACE率没有显著差异.
- 在CCTA加CT-FFR组1年发生的心脏事件较少 (0.5%对1.1%,P=.047).
结论:
- 将CT-FFR添加到CCTA有效地减少了在中国现实世界的环境中对侵入性冠状动脉血管学的需求.
- 该策略表明,与单独的CCTA相比,在一年内总体MACE率相似.
- 需要进一步的研究来证实CT-FFR引导管理的长期预后益处.


