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AHA 2014：CCTA筛查不改善糖尿病患者转归

2014-11-20 高晓方 译 医学论坛网

CCTA筛查糖尿病患者
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AHA科学年会公布的一项研究表明，在无症状的1或2型糖尿病患者中，应用冠脉CT血管造影(CCTA)筛查冠脉疾病未能改善患者死亡及心血管转归。研究者提出，不支持对这类患者进行CCTA筛查。论文11月17日在线发表于《美国医学会杂志》。[pdf free] 此项随机试验名为FACTOR-64研究，共纳入900例病程至少为3～5年且无冠脉疾病症状的1或2型糖尿病患者，并给予CCTA筛查冠脉

AHA科学年会公布的一项研究表明，在无症状的1或2型糖尿病患者中，应用冠脉CT血管造影(CCTA)筛查冠脉疾病未能改善患者死亡及心血管转归。研究者提出，不支持对这类患者进行CCTA筛查。论文11月17日在线发表于《美国医学会杂志》。[pdf free]


此项随机试验名为FACTOR-64研究，共纳入900例病程至少为3～5年且无冠脉疾病症状的1或2型糖尿病患者，并给予CCTA筛查冠脉疾病或基于指南的最佳糖尿病治疗。主要转归由全因死亡、非致命性心梗或需住院的不稳定性心绞痛组成，次要转归为缺血性严重不良心血管事件。评估CCTA常规筛查能否降低死亡和非致命性冠脉转归风险。


Figure 2.Kaplan-Meier Event Survival Curves for the Primary Composite End Point of Major Adverse Cardiovascular Events 

结果显示，在平均随访4.0年时，CCTA和对照组的主要转归事件发生率无显著差异[6.2%对7.6%;危险比(HR) 0.80，P=0.38]，缺血性严重不良心血管事件复合次要终点的发生率亦无显著差异(4.4%对3.8%;HR 1.15，P=0.68)。上述结果不支持在此类人群中实施CCTA筛查。

原始出处：

Muhlestein JB1, Lappé DL1, Lima JA2, Rosen BD2, May HT3, Knight S1, Bluemke DA4, Towner SR3, Le V3, Bair TL3, Vavere AL2, Anderson JL1.Effect of Screening for Coronary Artery Disease Using CT Angiography on Mortality and Cardiac Events in High-Risk Patients With Diabetes: The FACTOR-64 Randomized Clinical Trial.JAMA. 2014 Nov 17. doi: 10.1001/jama.2014.15825. [pdf free]

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    2015-06-08 ljjj1053

    非常好非常好

    0

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    2015-02-05 windight

    #CTA#

    0

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    2015-04-11 x35042875

    控制好糖尿病可能提高肝硬化患者的预后。

    0

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    2015-03-15 wshxjq

    #CCT#

    0

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    2014-11-22 zhaohui6731

    #AHA#

    0

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    2014-11-22 xue8604

    #糖尿病患者#

    0