PROMISE 研究结果发布
作者：国际心血管CT协会（SCCT） 学术委员会 翻译：GE Healthcare 张帅 博士
SAN DIEGO (March 14, 2015) – Today at the American College of Cardiology (ACC) Annual Scientific Sessions in San Diego, results from the keenly anticipated PROMISE clinical trial confirmed what many cardiologists and radiologists have long suspected to be true: coronary computed tomographic angiography (coronary CTA) is extraordinarily effective in accurately diagnosing patients with low to moderate chest pain. In most cases, coronary CTA is at least as effective as diagnostic methods such as stress tests such as SPECT myocardial perfusion imaging.
圣地亚哥（2015年3月14日）- 今天，在圣地亚哥举行的 2015 年美国心脏病协会学术年会上，众人期盼的 PROMISE 临床研究结果发布。PROMISE 研究证实了许多心脏病专家和放射专家的临床经验：冠状动脉 CTA（CCTA）在准确诊断中低危胸痛病人方面是非常有效的。在大多数情况下，CCTA 和 SPECT 负荷心肌灌注成像等功能学检查具备同等的诊断效能。
SCCT President Ricardo C. Cury, MD, FSCCT (Miami) observed that these findings demonstrate that coronary CTA plays a critical role in enabling physicians to determine and plan the best course of action in treating the millions of persons annually who present with low to moderate chest pain. Dr. Cury noted that “Today’s findings from PROMISE show that coronary CTA is a viable alternative to functional stress testing to assess symptomatic, intermediate risk patients for whom testing is currently recommended. This study should significantly impact daily clinical practice, with the potential to dramatically reduce the number of unnecessary invasive angiograms, stress tests and other resource-intensive procedures.”
SCCT 主席 Ricardo C. Cury 教授认为，这个结果说明 CCTA 将在每年数百万的胸痛的病人的诊疗中起到重要作用。Cury 教授说：“今天来自于 PROMISE 临床研究的结果显示，CCTA 是功能负荷检查的可靠替代方法，后者是目前评估中度风险、有症状冠心病人群的推荐检查方法。这项研究成果将显著影响常规诊疗流程，将大幅度减少不必要的有创冠脉造影、负荷检查和其他占用医疗资源的检查数量。”
President-Elect Jonathon A. Leipsic, MD, FSCCT (Vancouver) added that the impact of this study may go well beyond initial evaluation of the presenting patient, by helping physicians recommend the most appropriate long-term care for their patients. “These results are very exciting,” Dr. Leipsic stressed. “PROMISE affirms our experience in clinical practice, notably the apparent benefit of medical therapy on those uniquely identified by coronary CTA to have non-obstructive atherosclerosis. PROMISE appears to demonstrate that coronary CTA uniquely identifies a patients who have non-obstructive atherosclerosis and who will benefit from medical therapy. Interestingly, there was also a significant early benefit of the CTA strategy over functional imaging for decreasing hard events (death or non-fatal MI) in 12 months. This is extremely impactful data.”
SCCT 下任主席 Jonathon A. Leipsic 教授补充说，这项研究还将帮助心内科医生推荐最合适的病人长期治疗方案。“这些结果非常令人振奋，” Leipsic 教授强调，“PROMISE 研究证实了我们之前的临床经验： CCTA 具有独特的能力，发现那些无梗阻性粥样硬化的病人，这些病人将从治疗中获益。有意义的是，较功能成像而言，CCTA 检查在降低一年后恶性事件的发生（死亡或非致死性心肌梗死）方面有显著的早期价值。”
Commenting on the PROMISE trial’s potential impact on everyday medical practice, SCCT Vice President, Leslee J. Shaw, Ph.D (Atlanta) emphasized that “this is a very large and rigorously performed randomized trial comparing coronary CTA to functional testing. Although this is relatively new when compared to stress testing, results from PROMISE are very compelling and support expanded use of noninvasive CT angiography for evaluation of patients with stable chest pain. Clearly, the findings support expanded use of coronary CTA as an equally effective and safe procedure for patients presenting with suspected heart disease.”
“PROMISE 研究结果将影响冠心病的诊疗流程，” SCCT 副主席 Leslee J. Shaw 博士 强调：“这是一项严谨的、大样本的、随机试验，研究比较了CCTA 和功能检查。PROMISE 的结果非常具有说服力的。它支持在稳定性胸痛的病人的诊断流程中，可以更广泛的应用 CCTA。
PROMISE研究的全文已发表在《新英格兰医学杂志》：Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease