Место клинической оценки в выявлении обструктивных поражений коронарных артерий при стабильной ишемической болезни сердца. Часть II
Аннотация
В статье рассматриваются основные этапы диагностического процесса (клиническая оценка, определение претестовой вероятности, неинвазивные тесты). В данной части обзора рассмотрены два новых подхода к проведению неинвазивных тестов — с акцентом на неинвазивное определение анатомических изменений коронарного русла с помощью мультиспиральной компьютерной томографии-ангиографии, а также с вычислением посттестовой вероятности наличия обструктивной ишемической болезни сердца. В целом данный обзор поможет лучшему пониманию исследователей и клиницистов современных диагностических возможностей выявления обструктивной ишемической болезни сердца.
Об авторе
А. Н. Сумин
ФГБНУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний
Россия
Россия
Алексей Николаевич Сумин — доктор медицинских наук, зав. отделом мультифокального атеросклероза
Список литературы
1. Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012;60:e44-e164, doi:10.1016/j.jacc.2012.07.013.
2. Montalescot G, Sechtem U, Achenbach S, et al. Task Force Members; 2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949-3003. doi:10.1093/eurheartj/eht296.
3. Smeeth L, Skinner JS, Ashcroft J, et al. Chest Pain Guideline Development Group. NICE clinical guideline: chest pain of recent onset. Br J Gen Pract. 2010;60(577):607-10. doi:10.3399/bjgp10X515124.
4. Sechtem U, Mahrholdt H, Ong P, et al. Testing in patients with stable coronary artery disease — The debate continues. Circ J. 2016;80(4):802-10. doi:10.1253/circj.CJ-160220.
5. Сумин А. Н. Оценка предтестовой вероятности в диагностике обструктивных поражений коронарных артерий: нерешенные вопросы. Российский кардиологический журнал. 2017;22(11):68-76. doi:10.15829/1560-4071-2017-11-68-76.
6. Patel MR, Peterson ED, Dai D, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362(10):886-95. doi:10.1056/NEJMoa0907272.
7. Patel MR, Dai D, Hernandez AF, et al. Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. Am Heart J. 2014;167:846-52. doi:10.1016/j.ahj.2014.03.001.
8. Genders TS, Steyerberg EW, Alkadhi H, et al. A clinical prediction rule for the diagnosis of coronary artery disease: Validation, updating, and extension. Eur Heart J. 2011;32:1316-30. doi:10.1093/eurheartj/ehr014.
9. Douglas PS, Hoffmann U, Patel MR, et al. PROMISE Investigators: Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med 2015;372: 1291-300. doi:10.1056/NEJMoa1415516.
10. SCOT-HEART Investigators: CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOTHEART): an open-label, parallel-group, multicentre trial. Lancet. 2015;385:2383-91. doi:10.1016/S0140-6736(15)60291-4.
11. Genders TSS, Coles A, Hoffmann U, et al. CAD Consortium and the PROMISE Investigators. The external validity of prediction models for the diagnosis of obstructive coronary artery disease in patients with stable chest pain: insights from the PROMISE trial. J Am Coll Cardiol Img. 2018;11(3):437-46. doi:10.1016/j.jcmg.2017.02.020.
12. Adamson PD, Newby DE, Hill CL, et al. Comparison of International Guidelines for Assessment of Suspected Stable Angina: Insights From the PROMISE and SCOT-HEART. JACC Cardiovasc Imaging. 2018;11(9):1301-10. doi:10.1016/j.jcmg.2018.06.021.
13. Timmis A, Roobottom CA. National Institute for Health and Care Excellence updates the stable chest pain guideline with radical changes to the diagnostic paradigm. Heart. 2017;103(13):982-6. doi:10.1136/heartjnl-2015-308341.
14. Wolk MJ, Bailey SR, Doherty JU, et al. American College of Cardiology Foundation Appropriate Use Criteria Task Force. ACCF/AHA/ASE/ASNC/ HFSA/HRS/SCAI/SCCT/ SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;63:380-406. doi:10.1016/j.jacc.2013.
15. Hachamovitch R. Updating Algorithms for Predicting Pre-Test Likelihood of Coronary Artery Disease: A Cure for Inappropriate Testing? JACC Cardiovasc Imaging. 2018;11(3):447-9. doi:10.1016/j.jcmg.2017.03.017.
16. Rio P, Ramos R, Pereira-da-Silva T, et al. Yield of contemporary clinical strategies to detect patients with obstructive coronary artery disease. Heart Int. 2016;10(1):e12-9. doi:10.5301/heartint.5000224.
17. Fröhlich GM, Schoch B, Wolfrum M, et al. The impact of modern noninvasive cardiac imaging on coronary intervention rates. J Interv Cardiol. 2014;27(1):50-7. doi:10.1111/joic.12079.
18. Moss AJ, Williams MC, Newby DE, Nicol ED. The Updated NICE Guidelines: Cardiac CTas the First-Line Test for Coronary Artery Disease. Curr Cardiovasc Imaging Rep. 2017;10:15. doi:10.1007/s12410-017-9412-6.
19. Maron DJ, Hochman JS, O’Brien SM, et al. ISCHEMIA Trial Research Group. International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design. Am Heart J. 2018;201:124-35. doi:10.1016/j.ahj.2018.04.011.
20. Ma J, Ward EM, Siegel RL, Jemal A. Temporal trends in mortality in the United states, 1969-2013. JAMA. 2015;314:1731-9. doi:10.1001/jama.2015.12319.
21. Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med. 2007;356:2388-98.
22. Rozanski A, Gransar H, Hayes SW, et al. Temporal trends in the frequency of inducible myocardial ischemia during cardiac stress testing: 1991 to 2009. J Am Coll Cardiol 2013;61:1054-65. doi:10.1016/j.jacc.2012.11.056.
23. Ladapo JA, Blecker S, Douglas PS. Physician decision making and trends in the use of cardiac stress testing in the United States: an analysis of repeated cross-sectional data. Ann Intern Med. 2014;161:482-90. doi:10.7326/M14-0296.
24. Сумин АН, Корок ЕВ, Короткевич АА и др. Возможности однофотонной эмиссионной компьютерной томографии в диагностике обструктивных поражений коронарных артерий. Российский кардиологический журнал. 2017;22(12):14-20. doi:10.15829/1560-4071-2017-12-14-20.
25. Cremer PC, Nissen SE. The National Institute for Health and Care Excellence update for stable chest pain: poorly reasoned and risky for patients. Heart. 2017;103:972-4. doi:10.1136/heartjnl-2017-311410.
26. Kelion AD, Nicol ED. The rationale for the primacy of coronary CT angiography in the National Institute for Health and Care Excellence (NICE) guideline (CG95) for the investigation of chest pain of recent onset. J Cardiovasc Comput Tomogr. 2018;12(6):51622. doi:10.1016/j.jcct.2018.09.001.
27. Adamson PD, Hunter A, Williams MC, et al. Diagnostic and prognostic benefits of computed tomography coronary angiography using the 2016 National Institute for Health and Care Excellence guidance within a randomised trial. Heart. 2018;104:207-14. doi:10.1136/heartjnl-2017-311508.
28. Knuuti J, Ballo H, Juarez-Orozco LE, et al. The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a metaanalysis focused on post-test disease probability. Eur Heart J. 2018;39(35):3322-30. doi:10.1093/eurheartj/ehy267.
29. Stenström I, Maaniitty T, Uusitalo V, et al. Frequency and angiographic characteristics of coronary microvascular dysfunction in stable angina: a hybrid imaging study. Eur Heart J Cardiovasc Imaging. 2017;18(11):1206-13. doi:10.1093/ehjci/jex193.
30. Ong P, Athanasiadis A, Borgulya G, et al. Clinical usefulness, angiographic characteristics, and safety evaluation of intracoronary acetylcholine provocation testing among 921 consecutive white patients with unobstructed coronary arteries. Circulation. 2014;129(17):1723-30. doi:10.1161/CIRCULATIONAHA.113.004096.
31. Marzilli M, Merz CN, Boden WE, et al. Obstructive coronary atherosclerosis and ischemic heart disease: an elusive link! J Am Coll Cardiol. 2012;60(11):951-6. doi:10.1016/j.jacc.2012.02.082.
Для цитирования:
Сумин А.Н. Место клинической оценки в выявлении обструктивных поражений коронарных артерий при стабильной ишемической болезни сердца. Часть II. Российский кардиологический журнал. 2019;(8):111-115. https://doi.org/10.15829/1560-4071-2019-8-111-115
For citation:
Sumin, A.N. Place of clinical evaluation in the identification of obstructive coronary arteries lesions in patients with stable coronary artery disease: Part II. Russian Journal of Cardiology. 2019;(8):111-115. (In Russ.) https://doi.org/10.15829/1560-4071-2019-8-111-115
Просмотров: 148
Послать статью по эл. почте 
