Cardiology Department, Royal Brompton Hospital, London, UK.
Department of Acute Internal Medicine, Northumbria Healthcare NHS Foundation Trust, Northumbria Specialist Emergency Care Hospital, Cramlington, UK.
Br J Hosp Med (Lond). 2022 Aug 2;83(8):1-11. doi: 10.12968/hmed.2022.0176. Epub 2022 Aug 19.
Coronary artery disease continues to be the leading cause of morbidity and mortality worldwide. Recent clinical trials have not demonstrated any mortality benefit of percutaneous coronary intervention compared to medical management alone in the treatment of stable angina. While invasive coronary angiography remains the gold standard for diagnosing coronary artery disease, it comes with significant risks, including myocardial infarction, stroke and death. There have been significant advances in imaging techniques to diagnose coronary artery disease in haemodynamically stable patients. The latest National Institute for Health and Care Excellence and European College of Cardiology guidelines emphasise the importance of using these imaging techniques first to inform diagnosis. This review discusses these guidelines and imaging techniques, alongside their benefits and drawbacks.
冠心病仍然是全球发病率和死亡率的主要原因。最近的临床试验表明，与单纯药物治疗相比，经皮冠状动脉介入治疗在稳定型心绞痛的治疗中并没有带来任何生存获益。虽然有创冠状动脉造影仍然是诊断冠心病的金标准，但它也存在着显著的风险，包括心肌梗死、中风和死亡。在诊断血流动力学稳定的患者的冠心病方面，影像学技术取得了重大进展。最新的英国国家卫生与保健优化研究所和欧洲心脏病学会指南强调了首先使用这些影像学技术进行诊断的重要性。本文讨论了这些指南和影像学技术，以及它们的优点和缺点。
