Gray Alastair, McQuillan Conor, Menown Ian B A
Craigavon Cardiac Centre, Southern Trust, Craigavon, Northern Ireland, UK.
Adv Ther. 2017 Jul;34(7):1503-1527. doi: 10.1007/s12325-017-0560-5. Epub 2017 May 23.
The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016.
The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA). Selection criteria were trials with a broad relevance to the cardiology community and those with potential to change current practice.
A total of 57 key cardiology clinical trials were identified for inclusion. Here we describe and place in clinical context the key findings of new data relating to interventional and structural cardiology including delayed stenting following primary angioplasty, contrast-induced nephropathy, management of jailed wires, optimal duration of dual antiplatelet therapy (DAPT), stenting vs bypass for left main disease, new generation stents (BioFreedom, Orsiro, Absorb), transcatheter aortic valve implantation (Edwards Sapien XT, transcatheter embolic protection), and closure devices (Watchman, Amplatzer). New preventative cardiology data include trials of bariatric surgery, empagliflozin, liraglutide, semaglutide, PCSK9 inhibitors (evolocumab and alirocumab), and inclisiran. Antiplatelet therapy trials include platelet function monitoring and ticagrelor vs clopidogrel for peripheral vascular disease. New data are also presented in fields of heart failure (sacubitril/valsartan, aliskiren, spironolactone), atrial fibrillation (rivaroxaban in patients undergoing coronary intervention, edoxaban in DC cardioversion), cardiac devices (implantable cardioverter defibrillator in non-ischemic cardiomyopathy), and electrophysiology (cryoballoon vs radiofrequency ablation).
This paper presents a summary of key clinical cardiology trials during the past year and should be of practical value to both clinicians and cardiology researchers.
去年许多新的心脏病学临床试验结果已在主要国际会议上发表或公布。本文旨在描述并结合背景介绍2016年1月至12月期间公布的心脏病学关键临床试验总结。
作者回顾了2016年在主要心脏病学会议上公布的临床试验，包括美国心脏病学会（ACC）、欧洲经皮心血管介入协会（EuroPCR）、欧洲心脏病学会（ESC）、欧洲糖尿病研究协会（EASD）、经导管心血管治疗学术会议（TCT）以及美国心脏协会（AHA）。入选标准为与心脏病学界广泛相关且有可能改变当前临床实践的试验。
共确定57项关键心脏病学临床试验纳入本总结。在此，我们描述并结合临床背景介绍与介入心脏病学和结构性心脏病相关的新数据的关键发现，包括直接经皮冠状动脉腔内血管成形术后延迟支架置入、造影剂肾病、被困导丝的处理、双联抗血小板治疗（DAPT）的最佳持续时间、左主干病变的支架置入与搭桥手术、新一代支架（BioFreedom、Orsiro、Absorb）、经导管主动脉瓣植入术（Edwards Sapien XT、经导管栓塞保护装置）以及封堵装置（Watchman、Amplatzer）。心脏病预防方面的新数据包括减肥手术、恩格列净、利拉鲁肽、司美格鲁肽、前蛋白转化酶枯草溶菌素9（PCSK9）抑制剂（依洛尤单抗和阿利西尤单抗）以及inclisiran的试验。抗血小板治疗试验包括血小板功能监测以及替格瑞洛与氯吡格雷用于外周血管疾病的比较。心力衰竭（沙库巴曲/缬沙坦、阿利吉仑、螺内酯）、心房颤动（冠状动脉介入治疗患者使用利伐沙班、直流电复律时使用依度沙班）、心脏器械（非缺血性心肌病植入植入式心律转复除颤器）以及电生理（冷冻球囊与射频消融）等领域也有新数据公布。
本文呈现了过去一年心脏病学关键临床试验的总结，对临床医生和心脏病学研究人员均具有实际价值。
