Lessons learned from MPI and physiologic testing in randomized trials of stable ischemic heart disease: COURAGE, BARI 2D, FAME, and ISCHEMIA

被引：31

作者：

Phillips, Lawrence M. ^{[1
]}

Hachamovitch, Rory ^{[2
]}

Berman, Daniel S. ^{[3
]}

Iskandrian, Ami E. ^{[4
]}

Min, James K. ^{[5
]}

Picard, Michael H. ^{[6
]}

Kwong, Raymond Y. ^{[7
]}

Friedrich, Matthias G. ^{[8
]}

Scherrer-Crosbie, Marielle ^{[6
]}

Hayes, Sean W. ^{[3
]}

Sharir, Tali ^{[9
]}

Gosselin, Gilbert ^{[8
]}

Mazzanti, Marco ^{[10
]}

Senior, Roxy ^{[11
]}

Beanlands, Rob ^{[12
]}

Smanio, Paola ^{[13
]}

Goyal, Abhi ^{[14
]}

Al-Mallah, Mouaz ^{[15
]}

Reynolds, Harmony ^{[1
]}

Stone, Gregg W. ^{[16
]}

Maron, David J. ^{[17
]}

Shaw, Leslee J. ^{[14
]}

机构：

[1] NYU, Sch Med, New York, NY 10016 USA

[2] Cleveland Clin Fdn, Cleveland, OH 44195 USA

[3] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA

[4] Univ Alabama Birmingham, Birmingham, AL USA

[5] Weill Cornell Med Coll, New York, NY USA

[6] Massachusetts Gen Hosp, Boston, MA 02114 USA

[7] Brigham & WomensGuos Hosp, Boston, MA USA

[8] Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada

[9] Assuta Med Ctr, Tel Aviv, Israel

[10] Univ Hosp Ancona, Ancona, Italy

[11] Northwick Pk Hosp & Clin Res Ctr, London, England

[12] Ottawa Heart Inst, Ottawa, ON, Canada

[13] Inst Dante Pazzanese Cardiol, Sao Paulo, Brazil

[14] Emory Univ, Sch Med, Atlanta, GA USA

[15] King Abdulaziz Cardiac Ctr, Riyadh, Saudi Arabia

[16] Columbia Univ, New York Presbyterian Hosp, Med Ctr, New York, NY USA

[17] Vanderbilt Univ, Nashville, TN 37235 USA

来源：

JOURNAL OF NUCLEAR CARDIOLOGY | 2013年 / 20卷 / 06期

关键词：

Myocardial perfusion imaging; ischemia; coronary artery disease; clinical trials; CORONARY-ARTERY-DISEASE; FRACTIONAL FLOW RESERVE; EMISSION COMPUTED-TOMOGRAPHY; OPTIMAL MEDICAL THERAPY; OUTCOMES UTILIZING REVASCULARIZATION; MYOCARDIAL-PERFUSION SPECT; VENTRICULAR-FUNCTION; PROGNOSTIC VALUE; FOLLOW-UP; INTERVENTION;

D O I：

10.1007/s12350-013-9773-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

There is a preponderance of evidence that, in the setting of an acute coronary syndrome, an invasive approach using coronary revascularization has a morbidity and mortality benefit. However, recent stable ischemic heart disease (SIHD) randomized clinical trials testing whether the addition of coronary revascularization to guideline-directed medical therapy (GDMT) reduces death or major cardiovascular events have been negative. Based on the evidence from these trials, the primary role of GDMT as a front line medical management approach has been clearly defined in the recent SIHD clinical practice guideline; the role of prompt revascularization is less precisely defined. Based on data from observational studies, it has been hypothesized that there is a level of ischemia above which a revascularization strategy might result in benefit regarding cardiovascular events. However, eligibility for recent negative trials in SIHD has mandated at most minimal standards for ischemia. An ongoing randomized trial evaluating the effectiveness of randomization of patients to coronary angiography and revascularization as compared to no coronary angiography and GDMT in patients with moderate-severe ischemia will formally test this hypothesis. The current review will highlight the available evidence including a review of the published and ongoing SIHD trials.

引用

页码：969 / 975

页数：7