计算机断层扫描冠状动脉扫描与压力心声扫描在快速访问的胸痛诊所
Jacob P George1, Kate A Grunseit2, Manoj Rajamohan2
1Department of Cardiology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia.
在快速访问胸痛诊所 (RACPCs) 中,计算机断层扫描冠状动脉扫描 (CTCA) 导致与应激心声扫描 (SE) 相比,更多的侵入性手术和药物处方. 在患有心脏风险因素的男性中,CTCA更常见.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 门诊急诊胸痛诊所 (RACPCs) 通过使用非侵入性测试,如应激心声学 (SE) 和计算机断层扫描冠状动脉造影 (CTCA) 来管理低至中等风险的胸痛.
- 关于这些诊断测试如何影响RACPC患者的治疗结果的研究有限.
研究的目的:
- 为了比较RACPC中接受CTCA和SE的患者的风险概况,诊断和管理.
主要方法:
- 在RACPC中对903名患有低至中等风险胸痛的患者进行了一项回顾性,单中心的观察性研究.
- 根据心脏病学家的裁量权,对SE和/或CTCA的患者进行了调查.
主要成果:
- 在男性患者和那些具有先前存在的心脏风险因素的患者中,CTCA更频繁地使用.
- 接受CTCA的患者表现出更高的侵入性血管造影,冠状动脉干预和心脏专家转诊率.
- 在CTCA患者获得更多的抗血小板,抗高血压和降脂药物的处方,无论侵袭性手术.
结论:
- 压力心声扫描 (SE) 仍然是RACPCs中低至中等风险胸痛的常见初始测试.
- 计算机断层扫描冠状动脉扫描 (CTCA) 的使用因性别而异,男性更有可能最初接受它.
- 一个CTCA策略与侵袭性冠状动脉血管学,干预和开始心血管药物的增加有关.
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