最近ESC与ACC/AHA指南中的心脏计算机断层扫描建议的比较
Nicolas Dayer1, Nicola Ciocca2, Panagiotis Antiochos1
1Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland.
The international journal of cardiovascular imaging
|March 14, 2025
概括
这项研究比较了欧洲心脏病学会 (ESC) 和美国心脏病学会 (ACC) /美国心脏协会 (AHA) 的心脏计算机断层扫描 (CCT) 准则. 在ACC/AHA的指导方针中,比在ESC的指导方针中,有更多的CCT建议,其建议类别和证据水平更高.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 临床指南 临床指南
背景情况:
- 心脏计算机断层扫描 (CCT) 随着新应用和新技术的发展而扩大.
- 对CCT的临床实用性证据需要指导方针评估.
- 主要心脏病学会之间CCT建议的差异需要调查.
研究的目的:
- 在欧洲心脏病学会 (ESC) 和美国心脏病学会 (ACC) /美国心脏协会 (AHA) 的指南中比较CCT的指示.
- 在当前的CCT使用建议中确定共识和分歧.
- 在本指南中分析CCT的推类 (COR) 和证据水平 (LOE).
主要方法:
- 对最新的ESC和ACC/AHA关于CCT建议的指导方针进行系统审查.
- 使用统计测试 (χ2或费舍尔精确) 对COR和LOE进行比较分析.
- 在COR类别 (I,IIa,IIb,III) 和LOE (A,B,C) 中量化推分布.
主要成果:
- 经济与社会委员会的指导方针包括40个CCT建议 (45%COR-I,50%LOE-B).
- 在ACC/AHA的指导方针中,包括了54条CCT建议 (51.9%的COR-IIa,55.6%的LOE-B).
- 与ESC相比,ACC/AHA指南的COR-IIa建议比例显著更高 (P=0.04),总体上有更多的建议,COR和LOE较高.
结论:
- 在ACC/AHA指南中,比在ESC指南中提出的有更高COR和LOE的CCT建议更多.
- 在这两套指南之间,在CCT建议的数量和强度方面存在显著差异.
- 为了制定标准化,基于证据的CCT指导方针,需要进一步的研究和共识.
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