Cardiovascular Events in Women's Ischemia Syndrome Evaluation

女性缺血综合征评估中的心血管事件

• 批准号: 7682197
• 负责人: Sheryl F Kelsey
• 金额: $ 6.18万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7682197
• 关键词: Adenosine; Attention; Award; Blood Vessels; Cardiac; Cardiac Catheterization Procedures; Cardiovascular system; Cessation of life; Chest Pain; Confidentiality; Coronary; Coronary Angiography; Coronary Arteriosclerosis; Coronary heart disease; Data; Databases; Death Certificates; Diagnostic Procedure; Diagnostic tests; Disease; Evaluation; Evaluation Studies; Event; Female; Functional disorder; Funding; Genetic; Goals; Hormonal; Hormonal Risk Factor; Interview; Ischemia; Measures; Medical; Medical History; Myocardial Infarction; Myocardial Ischemia; Names; Nursing Research; Pain; Patients; Physicians; Prognostic Factor; Prospective Studies; Reporting; Risk Factors; Site; Symptoms; Syndrome; Techniques; Telephone; Time; Update; Woman; clinical research site; demographics; experience; follow-up; improved; indexing; longitudinal database; men; mortality; outcome forecast; psychosocial; public health relevance; response

DESCRIPTION (provided by applicant): The Women's Ischemia Syndrome Evaluation (WISE) study has been a successful and productive four-center prospective study of women clinically referred for coronary angiography for evaluation of symptoms suggestive of ischemia. Its major aims were to improve diagnostic testing for ischemic heart disease and to explore female-specific ischemic heart disease pathophysiology. Initiated in September 1996, recruitment of 936 women was completed in a timely manner by March 2000. Support was awarded for an additional five years of follow-up, and our database was closed in March 2006. A rich longitudinal database on these women is available. We are seeking funding to perform a National Death Index (NDI) search to extend mortality follow-up to an average of eight years (maximum 10 years). Patient names reside at the clinical sites, but to maintain confidentiality, are not included in the WISE database at the coordinating center. Experienced site coordinators will prepare materials to submit to the NDI and send results to the coordinating center. Updated mortality data will be added to the WISE database and analyzed. We will evaluate demographic medical history factors, hormonal status, psychosocial results of baseline diagnostic testing and genetic factors as predictors of mortality. Extension of cardiovascular mortality data will more clearly define prognostic factors for long-term mortality in women with ischemia with and without obstructive disease. With an additional targeted analysis, we will develop a simple, reproducible, angiographic technique to identify micro-vascular dysfunction, by correlating TIMI Frame Count with Doppler Wire determined coronary flow reserve measured in response to adenosine in WISE women with suspected ischemia but no significant coronary artery disease. Availability of a simple diagnostic technique allows clinicians to target these women for aggressive medical therapy aimed at early coronary artery disease and improved prognosis. PUBLIC HEALTH RELEVANCE: Much attention has been focused on the differences between men and women presenting with heart attacks and angina pain. The Women's Ischemia Syndrome Evaluation (WISE) study has been a successful and productive prospective study of women clinically referred for coronary angiography for evaluation of symptoms suggestive of ischemia. The goals of WISE were to improve diagnostic testing for ischemic heart disease and to explore female-specific ischemic heart disease pathophysiology. A National Death Index (NDI) search will be used to extend mortality follow-up for WISE women to an average of eight years (maximum 10). Experienced site coordinators will prepare materials to submit to NDI and send results to the coordinating center where updated mortality data will be added to the WISE database and analyzed. Using our existing database, coronary risk factors, hormonal status, psychosocial, genetic factors, and results of diagnostic tests will be evaluated as predictors of long-term mortality. L:\WISE\WISE R03\FINAL\Narrative.doc

描述（由申请人提供）：女性缺血综合征评价（WISE）研究是一项成功且富有成效的四中心前瞻性研究，研究对象为临床转诊接受冠状动脉造影术的女性，以评价提示缺血的症状。其主要目的是改善缺血性心脏病的诊断测试，并探讨女性特有的缺血性心脏病的病理生理学。1996年9月开始征聘936名妇女，到2000年3月及时完成。我们又提供了五年的后续支持，我们的数据库于2006年3月关闭。有关于这些妇女的丰富的纵向数据库。我们正在寻求资金进行国家死亡指数（NDI）搜索，以延长死亡率随访至平均8年（最长10年）。患者姓名存在于临床研究中心，但为了保密，未纳入协调中心的WISE数据库。经验丰富的研究中心协调员将准备提交给NDI的材料，并将结果发送给协调中心。将更新的死亡率数据添加到WISE数据库中并进行分析。我们将评估人口统计学病史因素、激素状态、基线诊断测试的心理社会结果和遗传因素作为死亡率的预测因素。心血管死亡率数据的扩展将更清楚地定义缺血伴或不伴阻塞性疾病的女性长期死亡率的预后因素。通过额外的靶向分析，我们将开发一种简单的、可重复的血管造影技术，通过将TIMI帧数与多普勒导丝测定的冠状动脉血流储备相关联来识别微血管功能障碍，所述冠状动脉血流储备是在疑似缺血但无显著冠状动脉疾病的WISE女性中对腺苷的反应。一个简单的诊断技术的可用性允许临床医生针对这些妇女积极的药物治疗，旨在早期冠状动脉疾病和改善预后。公共卫生相关性：很多注意力都集中在男性和女性心脏病发作和心绞痛之间的差异上。女性缺血综合征评价（WISE）研究是一项成功且富有成效的前瞻性研究，研究对象为临床转诊接受冠状动脉造影的女性，以评价提示缺血的症状。WISE的目标是改善缺血性心脏病的诊断测试，并探索女性特异性缺血性心脏病的病理生理学。国家死亡指数（NDI）搜索将用于将WISE女性的死亡率随访延长至平均8年（最长10年）。经验丰富的研究中心协调员将准备材料提交给NDI，并将结果发送给协调中心，在协调中心，更新的死亡率数据将添加到WISE数据库中并进行分析。使用我们现有的数据库，冠状动脉危险因素，激素状态，心理，遗传因素和诊断测试的结果将被评估为长期死亡率的预测因素。L：\WISE\WISE R03\FINAL\Narrative.doc