计算机断层扫描冠状动脉扫描 (CTCA) 单独与选择性FFRCT的CTCA在患有稳定胸痛的患者中进行比较:FORECAST试验替代研究
Mohamed Kira1,2, Lavinia Gabara1,2, Mohamed Abouelasaad1
1Coronary & Structural Heart Research Group, University Hospital Southampton NHS FT, Tremona Road, Southampton SO16 6YD, UK.
European heart journal. Imaging methods and practice
|October 9, 2025
概括
计算断层扫描冠状动脉扫描 (CTCA) 与分数流量储备 (FFRCT) 策略在胸痛患者中与单独使用CTCA相比,成本中立,并减少了额外的非侵入性测试和管理计划的时间.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 卫生经济学 卫生经济学
背景情况:
- 在FORECAST试验中,计算断层扫描冠状动脉扫描 (CTCA) 和选择性分流储备 (FFRCT) 与胸痛患者的标准护理进行了评估.
- 本分析的重点在于患者更喜欢CTCA作为初始测试,比较CTCA + FFRCT与单独CTCA.
研究的目的:
- 在随机化之前选择接受CTCA的患者中,比较CTCA+选择性FFRCT与单独CTCA的结果.
- 评估心脏成本,使用其他测试,临床事件和管理计划的时间.
主要方法:
- 预先对预测试验数据进行预规定的分析.
- 意图测试分析比较CTCA层中随机化后的结果.
- 比较CTCA + FFRCT臂与CTCA单独臂.
主要成果:
- 在CTCA+FFRCT和单独CTCA之间9个月的心脏总成本没有显著差异 (£594对£594,P=0.325).
- 在CTCA+FFRCT组中,显著减少了额外的非侵入性测试 (8.9%对16%,P=0.005).
- 在CTCA+FFRCT组中,最终管理计划的时间显著缩短 (中位数为64天而不是75天,P<0.001).
- 在不良心脏事件中没有显著差异.
结论:
- CTCA + FFRCT策略在成本上是中性的,并减少了进一步的非侵入性测试的需要.
- 这一策略显著加快了胸痛患者最终管理计划的时间.
- 对于最初被选中接受CTCA的患者来说,CTCA + FFRCT提供了一个有效的方法.
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