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随机对照试验:早期磁控胶囊内镜预防高出血风险拟行经皮冠状动脉介入治疗患者的胃肠道出血:MACE-GPS 研究方案。

Randomised controlled trial of early magnetically controlled capsule endoscopy for the prevention of gastrointestinal bleeding in patients at high bleeding risk scheduled for percutaneous coronary intervention: MACE-GPS study protocol.

机构信息

Department of Cardiology, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Department of Cardiology, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

出版信息

BMJ Open. 2024 Jan 22;14(1):e077852. doi: 10.1136/bmjopen-2023-077852.

Abstract

INTRODUCTION

Limited data are available regarding the decision-making process for preventing gastrointestinal bleeding in patients at high risk of bleeding scheduled for percutaneous coronary intervention (HBPCI), especially due to the lack of a simple, accurate and sensitive methods for gastrointestinal injury detection. This randomised trial aims to assess the effects of early magnetically controlled capsule endoscopy (MCE) in patients with HBPCI for the prevention of gastrointestinal bleeding compared with conventional management.

METHODS AND ANALYSIS

The Magnetic-Assisted Capsule Endoscopy Gastrointestinal bleeding Protection Strategy (MACE-GPS) is a multicentre, open-label, randomised controlled trial. Patients admitted for HBPCI will be randomised and placed into two study groups. In the early MCE group, 1228 patients will undergo MCE following admission to the hospital. If necessary, these patients may further undergo a multidisciplinary approach to determine treatment based on the MCE findings. A total of 1228 patients in the control group will undergo conventional treatment based on the attending cardiologist's interpretation of their clinical presentations. The primary end point is the incidence of gastrointestinal bleeding within 12 months of enrolment.

ETHICS AND DISSEMINATION

The MACE-GPS trial has been approved by the ethics committees of all participating sites. Participant recruitment began in April 2023 and will be completed in April 2025, and the 1-year follow-up will be completed in April 2026. The study results will be disseminated through conference presentations and peer-reviewed publications.

TRIAL REGISTRATION NUMBER

ChiCTR2300070025.

摘要

简介

关于接受经皮冠状动脉介入治疗(HBPCI)的高危出血患者预防胃肠道出血的决策过程,相关数据有限,尤其是缺乏一种简单、准确和敏感的胃肠道损伤检测方法。本随机试验旨在评估 HBPCI 患者中早期磁控胶囊内镜(MCE)在预防胃肠道出血方面的效果,与常规治疗相比。

方法和分析

磁辅助胶囊内镜胃肠道出血保护策略(MACE-GPS)是一项多中心、开放标签、随机对照试验。将随机分配并将入院接受 HBPCI 的患者分为两组。在早期 MCE 组中,1228 名患者将在入院后接受 MCE。如果有必要,这些患者可能会进一步采用多学科方法根据 MCE 结果确定治疗方案。对照组 1228 名患者将根据主治心脏病专家对其临床表现的解释进行常规治疗。主要终点是登记后 12 个月内胃肠道出血的发生率。

伦理和传播

MACE-GPS 试验已获得所有参与地点的伦理委员会的批准。参与者招募于 2023 年 4 月开始,将于 2025 年 4 月完成,1 年随访将于 2026 年 4 月完成。研究结果将通过会议演讲和同行评审出版物传播。

试验注册号

ChiCTR2300070025。

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