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SCOT-HEART trial: reshuffling our approach to stable ischemic heart disease.
SCOT-HEART试验: 重组我们的方法治疗稳定的缺血性心脏病。
- 影响因子:2.12
- DOI:10.1259/bjr.20190763
- 作者列表:"Amin SB","Stillman AE
- 发表时间:2020-09-01
Abstract
:The role of diagnostic testing in triaging patients with stable ischemic heart disease continues to evolve towards recognizing the benefits of coronary CT angiography (CCTA) over functional testing. The SCOT-HEART (Scottish Computed Tomography of the HEART) trial highlights this paradigm shift finding a significant reduction of death from coronary heart disease or non-fatal myocardial infarction without a significant increased rate of invasive coronary angiography over a 5 year follow-up period when implementing CCTA with standard care vs standard care alone. The better negative predictive value and ability to identify nonobstructive coronary artery disease to optimize medical therapy highlight the benefits of a CCTA first strategy. With the advent of noninvasive fractional flow reserve (FFR) and widespread availability and ease of CT, CCTA continues to establish itself as a pivotal diagnostic exam for patients with stable ischemic heart disease. In this commentary, we review the SCOT-HEART trial and its impact on CCTA for patients with stable ischemic heart disease.
摘要
: 诊断测试在对稳定性缺血性心脏病患者进行分类中的作用继续发展,以认识到冠状动脉CT血管造影 (CCTA) 优于功能测试的益处。苏格兰心脏 (苏格兰心脏计算机断层扫描) 试验强调了这一模式的转变,发现在5年的随访期内,与单纯实施标准护理相比,实施标准护理的CCTA显著降低了冠心病或非致命性心肌梗死的死亡率,但侵入性冠状动脉造影的发生率却没有显著增加。更好的阴性预测值和识别非阻塞性冠状动脉疾病以优化药物治疗的能力突出了CCTA第一策略的益处。随着无创血流储备分数 (FFR) 的出现以及CT的广泛可用性和简易性,CCTA继续将其自身确立为稳定缺血性心脏病患者的关键诊断检查。在这篇评论中,我们回顾了SCOT-HEART试验及其对稳定性缺血性心脏病患者CCTA的影响。
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