经导管主动脉瓣植入术患者冠状动脉疾病的术前评估:EASE-IT CT 登记的原理和设计。

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Julia Mascherbauer, Tanja Rudolph, Justus T. Strauch, Moritz Seiffert, Sabine Bleiziffer, Philipp Emanuel Bartko, Marie Zielinski, Anjaly Vijayan, Peter Bramlage, Christian Hengstenberg
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引用次数: 0

摘要

背景:有创冠状动脉造影术(ICA)是经导管主动脉瓣植入术(TAVI)患者术前评估冠状动脉疾病(CAD)的标准方法。然而,它需要住院治疗,并可能伴有并发症。计算机断层扫描血管造影(CTA)可能是排除与预后相关的冠状动脉疾病的可行替代方法:EASE-IT CT 注册是一项由研究者发起的前瞻性、观察性、多中心试点注册,涉及年龄≥75 岁、患有严重主动脉瓣狭窄(AS)、打算植入 SAPIEN 系列经导管心脏瓣膜(THV)的患者。将从德国和奥地利的四个地点招募 150 名患者。登记将由两个前瞻性队列组成:纯 CTA 研究队列和 CTA + ICA 对照队列。纯 CTA 队列将招募 100 名经 CTA 排除左主干动脉 (LM) 和/或左前降支动脉 (LAD) 近端明显(≥50%)狭窄的患者。CTA+ICA对照组将纳入50名患者,这些患者在TAVI前均接受过CTA和ICA检查,且CTA已排除LM/LAD近端≥50%的狭窄。TAVI 术后 3 个月将评估三个综合终点:CAD特异性终点、VARC-3定义的设备成功率和早期安全性:结论:EASE-IT CT 注册研究评估了如果通过 CTA 排除了 LM/LAD 近端与预后相关的 CAD,是否可以在不进行 ICA 的情况下安全实施 TAVI。如果可以,省略 ICA 将有助于简化 TAVI 患者的术前检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Preprocedural assessment of coronary artery disease in patients undergoing transcatheter aortic valve implantation: Rationale and design of the EASE-IT CT registry

Preprocedural assessment of coronary artery disease in patients undergoing transcatheter aortic valve implantation: Rationale and design of the EASE-IT CT registry

Background

Invasive coronary angiography (ICA) is the standard for pre-procedural assessment of coronary artery disease (CAD) in patients undergoing transcatheter aortic valve implantation (TAVI). However, it requires hospitalization and can be associated with complications. Computed tomography angiography (CTA) may be a viable alternative to rule out prognostically relevant CAD.

Methods

The EASE-IT CT Registry is an investigator-initiated, prospective, observational, multicentre pilot registry involving patients aged ≥75 years with severe aortic stenosis (AS) intended to implant a transcatheter heart valve (THV) of the SAPIEN family. A total of 150 patients will be recruited from four sites in Germany and Austria. The registry will consist of two prospective cohorts: the investigational CTA-only cohort and the CTA + ICA control cohort. The CTA-only cohort will enrol 100 patients in whom significant (≥50%) left main (LM) and/or proximal left anterior descending artery (LAD) stenosis are ruled out on CTA. The CTA + ICA control cohort will enrol 50 patients who have undergone both CTA and ICA before TAVI and in whom ≥50% LM/proximal LAD stenosis has been ruled out by CTA. Three composite endpoints will be assessed at 3 months post-TAVI: CAD-specific endpoints, VARC-3-defined device success and early safety.

Conclusion

The EASE-IT CT Registry evaluates whether TAVI can be carried out safely without performing ICA if prognostically relevant CAD of the LM/proximal LAD is ruled out with CTA. If so, the omission of ICA would help streamline the pre-procedural workup of TAVI patients.

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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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