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单独采用引流术或心包穿刺术治疗复发性非恶性、非细菌性心包积液(需进行干预):DROP试验的原理与设计,一项随机、开放标签、多中心研究

DRainage Or Pericardiocentesis alone for recurrent nonmalignant, nonbacterial pericardial effusions requiring intervention: rationale and design of the DROP trial, a randomized, open-label, multicenter study.

作者信息

Imazio Massimo, Belli Riccardo, Beqaraj Federico, Giammaria Massimo, Lestuzzi Chiara, Hoit Brian, LeWinter Martin, Spodick David H, Adler Yehuda

机构信息

aCardiology Department, Maria Vittoria Hospital, Torino bCardiology CRO, National Cancer Institute, Aviano, Italy cHarrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, Ohio dCardiology Unit, Fletcher Allen Healthcare, Burlington eInternal Medicine Department, St. Vincent Hospital, Worcester, Massachusetts, USA fChaim Sheba Medical Center, Tel Hashomer and Sacker Faculty of Medicine, Tel Aviv, Israel.

出版信息

J Cardiovasc Med (Hagerstown). 2014 Jun;15(6):510-4. doi: 10.2459/JCM.0b013e3283621d26.

Abstract

OBJECTIVES

Evidence to support the use of pericardial drainage instead of simple pericardiocentesis for nonmalignant pericardial effusions refractory to medical therapy is based on observational studies and experts' opinions, rather than randomized trials. The aim of the present trial is to fill this knowledge gap and to provide a stronger base of evidence to support a specific interventional treatment in this setting.

METHODS

DRainage Or Pericardiocentesis (DROP) alone for recurrent nonmalignant, nonbacterial pericardial effusions requiring intervention is a randomized, open-label and multicenter study. The primary efficacy endpoints are the incidence of recurrent pericardial effusion, and the need for additional pericardiocentesis or cardiac surgery at 12 months. Secondary endpoints are hospital length stay, disease-related admission and overall mortality. Safety and complications rates of each intervention will be also assessed.

IMPLICATIONS AND CONCLUSION

The DROP trial will be the first multicenter randomized trial to evaluate the efficacy and safety of pericardiocentesis versus pericardiocentesis and extended pericardial drainage for recurrent nonmalignant, nonbacterial pericardial effusions refractory to medical therapy and requiring interventional treatments (ClinicalTrials.gov Identifier: NCT01665495).

摘要

目的

支持采用心包引流而非单纯心包穿刺术治疗药物治疗无效的非恶性心包积液的证据,是基于观察性研究和专家意见,而非随机试验。本试验的目的是填补这一知识空白,并为支持在这种情况下进行特定的介入治疗提供更有力的证据基础。

方法

单独采用引流或心包穿刺术治疗复发性非恶性、非细菌性心包积液(DROP)是一项随机、开放标签的多中心研究。主要疗效终点是心包积液复发的发生率,以及12个月时进行额外心包穿刺术或心脏手术的必要性。次要终点是住院时间、与疾病相关的入院情况和总死亡率。还将评估每种干预措施的安全性和并发症发生率。

意义与结论

DROP试验将是第一项多中心随机试验,用于评估心包穿刺术与心包穿刺术加心包延长引流术治疗复发性非恶性、非细菌性心包积液(药物治疗无效且需要介入治疗)的疗效和安全性(ClinicalTrials.gov标识符:NCT01665495)。

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