medicina57巻10号

2020年09月発行

特集 循環器診療2020—どこまで攻めて，どこから引くか？

虚血性心疾患

ISCHEMIA試験後の安定狭心症治療—今のカテの立ち位置は？

著者： 竹中秀¹ 永井利幸¹

所属機関： ¹北海道大学大学院医学研究院循環病態内科学教室

ページ範囲：P.1690 - P.1695

文献概要

Point
◎ISCHEMIA試験は，中等度以上の虚血所見を有する安定狭心症に対する冠血行再建の有効性を検討した大規模無作為化試験であるが，冠血行再建の予後改善効果は示されなかった．
◎安定狭心症に対する冠血行再建の適応適切性基準が提唱されているが，ISCHEMIA試験の結果を受け，今後は血行再建の適切性をより限定する方向に改定されるものと予想される．
◎ISCHEMIA試験以降，本邦においても“盲目的”な冠動脈造影・血行再建術は生命予後や医療費の観点からも，控える方向に舵を切らざるを得ない段階に来ていると考えられる．

参考文献

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