COURAGE CLINICAL OUTCOMES UTILIZING REVASCULARIZATION & AGGRESSIVE DRUG EVAL

勇气利用血运重建的临床结果

• 批准号: 7376566
• 负责人: ERIC R BATES
• 金额: $ 3.78万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-05 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376566
• 关键词: artery; blood; coronary artery; coronary disorder; heart; intraluminal angioplasty; medicine; myocardial infarction; quality of life

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Coronary artery disease is a process that results in "hardening the arteries." When the arteries that supply blood and oxygen to your heart muscle become clogged or narrowed, a heart attack may result, or you may feel chest discomfort (angina) sometimes even while resting. The best treatment for patients like yourself with coronary artery disease is unclear. There are three kinds of approaches: treatment with medicines, coronary artery bypass (open heart) surgery, and balloon angioplasty. Balloon angioplasty has been used safely in patients like yourself for over 15 years. It is a technique for widening the narrowed arteries in the heart by either inflating a small balloon placed in the narrowed area or using a special device (rotoblator) to burrow through, or shave (directional atherectomy), plaques of calcium from the narrowed areas. Sometimes a small expandable stainless steel mesh tube (stent) is placed in the artery to assist it in remaining open. It has not been proven in patients like yourself whether those who have balloon angioplasty live longer, have fewer heart attacks, or have a better quality of life than those who only have medicine. The American Heart Association has developed guidelines for intensive treatment of patients with coronary artery disease with medicines. These medicines include aspirin, drugs that decrease the work of the heart (beta-blockers), drugs that relax the coronary arteries so that more blood can flow through the narrowed artery (nitroglycerin, calcium channel blockers), drugs that lower blood pressure, drugs that decrease cholesterol and blood fats, and for women, an estrogen supplement. In addition to medicines, these guidelines include recommendations to pay attention to diet and exercise and to stop smoking. The purpose of this study is to determine whether in patients like yourself, adding balloon angioplasty to the medical therapy suggested by the American Heart Association will result in fewer deaths and heart attacks or a better quality of life than treatment with medical therapy alone. All patients receive maximum medical therapy and half of the patients will receive a percutaneous procedure (PCI). Patients will be followed for 3-5 years to follow their cardiac symptoms.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。冠状动脉疾病是一个导致“动脉硬化"的过程。“当为心肌提供血液和氧气的动脉堵塞或狭窄时，可能会导致心脏病发作，或者即使在休息时，有时也会感到胸部不适（心绞痛）。对于像你这样的冠心病患者，最好的治疗方法还不清楚。有三种方法：药物治疗，冠状动脉搭桥术（心脏直视手术）和球囊血管成形术。球囊血管成形术已经安全地用于像你这样的病人超过15年。它是一种用于扩大心脏狭窄动脉的技术，通过在狭窄区域放置一个小球囊或使用一种特殊的设备（旋切器）来钻穿或刮除（定向斑块切除术）狭窄区域的钙斑块。有时，一个小的可膨胀的不锈钢网状管（支架）被放置在动脉中，以帮助它保持开放。在像你这样的患者中，还没有证明那些接受球囊血管成形术的人是否比那些只接受药物治疗的人活得更长，心脏病发作更少，或者生活质量更好。美国心脏协会已经制定了对冠状动脉疾病患者进行药物强化治疗的指南。这些药物包括阿司匹林，降低心脏工作的药物（β受体阻滞剂），放松冠状动脉的药物，以便更多的血液可以通过狭窄的动脉（硝酸甘油，钙通道阻滞剂），降低血压的药物，降低胆固醇和血脂的药物，以及女性雌激素补充剂。除了药物外，这些指南还包括注意饮食和锻炼以及戒烟的建议。这项研究的目的是确定在像你这样的患者中，将球囊血管成形术添加到美国心脏协会建议的药物治疗中是否会导致更少的死亡和心脏病发作，或者比单独使用药物治疗更好的生活质量。所有患者均接受最大限度的药物治疗，一半患者将接受经皮手术（PCI）。将对患者进行3-5年的随访，以跟踪其心脏症状。