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拟议的心血管临床试验标准化神经终点:学术研究联盟倡议。

Proposed Standardized Neurological Endpoints for Cardiovascular Clinical Trials: An Academic Research Consortium Initiative.

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.

Yale Cardiovascular Research Group, New Haven, Connecticut.

出版信息

Eur Heart J. 2018 May 14;39(19):1687-1697. doi: 10.1093/eurheartj/ehx037.

Abstract

Surgical and catheter-based cardiovascular procedures and adjunctive pharmacology have an inherent risk of neurological complications. The current diversity of neurological endpoint definitions and ascertainment methods in clinical trials has led to uncertainties in the neurological risk attributable to cardiovascular procedures and inconsistent evaluation of therapies intended to prevent or mitigate neurological injury. Benefit-risk assessment of such procedures should be on the basis of an evaluation of well-defined neurological outcomes that are ascertained with consistent methods and capture the full spectrum of neurovascular injury and its clinical effect. The Neurologic Academic Research Consortium is an international collaboration intended to establish consensus on the definition, classification, and assessment of neurological endpoints applicable to clinical trials of a broad range of cardiovascular interventions. Systematic application of the proposed definitions and assessments will improve our ability to evaluate the risks of cardiovascular procedures and the safety and effectiveness of preventive therapies.

摘要

外科和基于导管的心血管手术以及辅助药理学都存在神经并发症的固有风险。目前临床试验中神经终点定义和确定方法的多样性导致了归因于心血管手术的神经风险的不确定性,以及对旨在预防或减轻神经损伤的治疗方法的评估不一致。此类手术的获益-风险评估应基于对明确的神经结果的评估,这些结果应通过一致的方法确定,并涵盖全谱的神经血管损伤及其临床影响。神经学术研究联盟是一个国际合作组织,旨在就适用于广泛心血管干预临床试验的神经终点的定义、分类和评估达成共识。系统应用拟议的定义和评估将提高我们评估心血管手术风险以及预防治疗安全性和有效性的能力。

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