资源和外部结果 路线的影响 计算机断层扫描 perfusion 的可用性
Andrea Baggiano1,2, Riccardo Maragna1, Saima Mushtaq1
1Centro Cardiologico Monzino IRCCS, Milan, Italy.
常规压力计算断层扫描输液 (Stress-CTP) 有效地识别了需要冠状动脉疾病 (CAD) 重血管化的患者. 在Stress-CTP上没有诱导性缺血,可以安全地推迟侵入性手术,降低心脏不良事件.
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:
- 冠状动脉疾病 (CAD) 管理从功能评估中获益.
- 冠状动脉计算机断层扫描血管造影 (cCTA) 和压力计算机断层输液 (Stress-CTP) 提供了综合的解剖学和功能评估.
- 综合cCTA和压力-CTP的常规实施旨在改善患者的护理.
研究的目的:
- 评估常规联合cCTA和压力-CTP在中等至高CAD风险或已知症状CAD的患者中的影响.
- 为了评估这种综合成像方法的现实世界的有效性.
主要方法:
- 未来的注册表研究 (ROUTINE-CTP注册表).
- 包括中等至高CAD风险或已知的症状CAD的患者.
- 收集有关辐射暴露,重新分类率,非侵入性检测,侵入性冠状动脉血管学 (ICA) 转诊,再血管化和主要不良心脏事件 (MACE) 的数据.
主要成果:
- 263名患者 (平均年龄65±9岁,79%男性) 参与了这项研究.
- 对cCTA (95%) 和压力-CTP (99%) 的高可评估率.
- 在压力-CTP时诱导性缺血是重血管化的主要预测因子 (HR 20.08).
- 缺少可诱导性缺血和阻塞性CAD预测没有冠状动脉相关的MACE.
结论:
- 在压力-CTP上诱导性缺血是冠状动脉再血管化的关键预测因素.
- 没有 perfusion 缺陷,可以安全推迟进一步的侵入性检测.
- 结合cCTA和压力-CTP可以提高诊断产量,甚至可以识别患有阻塞性CAD的低风险个体.
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