基于风险的精确测试策略与疑似冠状动脉疾病的稳定患者的通常测试相比,生活质量结果:来自PRECISE随机试验的结果
Daniel B Mark1,2, Yanhong Li1, Michael G Nanna3
1Duke Clinical Research Institute, Duke University, Durham, NC (D.B.M., Y.L., M.D.K., M.R.D., M.R.P., K.N.B., S.V., P.S.D.).
Circulation. Cardiovascular quality and outcomes
|February 3, 2025
概括
在患有稳定胸痛的患者中,生命质量在6个月内显著改善,无论他们是否接受了精确诊断测试或常规护理. 这两种策略都产生了类似的健康结果.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 健康 结果 研究 研究 结果
背景情况:
- PRECISE试验评估了精确诊断测试策略与常规测试对照,该策略用于稳定胸痛和疑似冠状动脉疾病的患者.
- 生活质量 (QOL) 是这项前性随机试验的关键次要终点.
研究的目的:
- 为了比较精确诊断测试策略和稳定胸痛患者的常规测试之间的QOL结果.
- 评估不同诊断策略对患者报告的健康状况和满意度的影响.
主要方法:
- 在基线和随机化后的45天,6个月和12个月,使用结构化采访评估QOL,包括西雅图心痛问卷 (SAQ-19) 和EQ-5D,在基线和45天,6个月和12个月后随机化.
- 主要的QOL比较侧重于6个月的SAQ总结得分,高数据收集率确保了可靠的分析.
- 基于每个患者的初始随机分配,进行了比较.
主要成果:
- 精确策略和常规测试组都显示了从基线到6个月的SAQ总结平均得分的实质性改善.
- 在任何随访点上,两组之间没有观察到SAQ得分或通用健康状况 (EQ-5D) 的统计学上显著或临床上有意义的差异.
- 在6个月后,两组同样比例的患者 (66%) 没有胸痛,护理满意度高且可比.
结论:
- 在怀疑冠状动脉疾病的稳定患者中,在前6个月内,与心痛相关的和整体的QOL显著改善.
- 观察到的质量生活改善独立于所采用的诊断测试策略 (精度与常规护理).
- 这些发现表明,目前的诊断方法在这个患者群体中有效地管理了QOL.
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