常规监测压力测试在有或没有成像指导或生理指导PCI的患者中的作用
Yeonwoo Choi1,2, Do-Yoon Kang2, Hoyun Kim2
1Division of Cardiology, Hanmaeum Changwon Hospital, Hanyang University Medical Center, Changwon, Korea.
通过皮肤冠状动脉干预 (PCI) 后的常规监测应激测试对高风险患者没有临床益处,无论成像指导如何. 这种方法增加了侵入性手术而没有改善结果,支持目前反对其使用的指导方针.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床试验 临床试验
背景情况:
- 高风险患者皮肤穿刺冠状动脉干预 (PCI) 后的最佳随访尚不清楚.
- 调查常规监控压力测试与PCI后的标准护理.
研究的目的:
- 为了确定PCI后的常规监控应激测试是否提供临床益处.
- 在PCI期间根据血管内超声波 (IVUS) 或分流储备 (FFR) 的指导来评估益处.
主要方法:
- 在接受PCI的1706名高风险患者的随机试验中.
- 一年后常规功能检测与单独标准护理的比较.
- 在索引过程中基于IVUS或FFR使用的子组分析.
主要成果:
- 在常规检测和标准护理之间,在2年后的初级结局 (死亡,心脏病发作,不稳定的心痛住院) 中没有显著差异.
- 无论IVUS或FFR指导,结果都是相似的.
- 常规检测导致侵入性血管造影的增加和重复的血管化,没有临床益处.
结论:
- 在PCI后进行例行监测压力测试不会改善高风险患者的临床结果.
- 使用IVUS或FFR并不会改变没有益处的情况.
- 这些发现支持目前的指导方针,建议不要进行PCI后的常规监测测试.
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