慢性冠状动脉综合征综合诊断,结合血管造影和冠状动脉内检测:AID-ANGIO研究
Adrián Jerónimo1, José G Paredes-Vázquez1, Alejandro Travieso1
1Department of Cardiology, Hospital Clínico San Carlos IDISSC, CIBER-CV, Madrid, Spain and Universidad Complutense de Madrid, Madrid, Spain.
一种先进的侵入性诊断 (AID) 策略显著增加了慢性冠状动脉综合征 (CCS) 患者心肌缺血的原因的检测. 这种结合血管学和冠状动脉内检测的方法可以识别非阻塞性冠状动脉疾病 (INOCA) 并修改治疗计划.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 干预心脏病学 干预心脏病学
背景情况:
- 对于慢性冠状动脉综合征 (CCS) 的侵入性冠状动脉血管学 (ICA) 的诊断准确性在当前的医疗实践中仍然不确定.
- 需要改进诊断策略,以确定心肌缺血的原因.
研究的目的:
- 评估先进的侵入性诊断 (AID) 策略的诊断价值,将血管造影与冠状动脉内检测相结合.
- 评估AID策略对CCS患者治疗决策的影响.
主要方法:
- 在AID-ANGIO研究中,前性注册了317名CCS患者,这些患者被转介给ICA.
- 阻塞性冠状动脉疾病 (CAD) 使用血管造影和压力导线进行评估.
- 在没有阻塞性冠状动脉时,进行了针对非阻塞性冠状动脉缺血的冠状动脉内检测 (INOCA).
主要成果:
- 在84.2%的患者中,AID策略确定了心肌缺血的原因,这与单独使用ICA相比显著增加 (32.2%).
- 在39.1%的患者中发现了阻塞性CAD,在45.1%的患者中发现了INOCA.
- 在59.9%的病例中,AID策略导致了最初治疗计划的修改.
结论:
- 与ICA相比,AID策略的诊断收益率对于产生缺血的冠状动脉异常是2.6倍.
- 鉴定INOCA显著促进了诊断产量的增加.
- 辅助治疗策略在很大程度上影响了CCS患者的治疗计划.
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