对于心脏病，药物可能与侵入性手术一样有效

对于心脏病，药物可能与侵入性手术一样有效

High-risk patients with stable heart disease may fare just as well on medications alone, versus having invasive heart operations such as stents and bypass surgeries, according to a major trial. The results were presented Saturday at the American Heart Association's yearly conference.

一项大型试验显示，与接受支架和搭桥手术等侵入性心脏手术相比，患有稳定心脏病的高风险患者仅接受药物治疗可能效果一样好。研究结果于周六在美国心脏协会的年度会议上公布。

While the invasive procedures were found to improve chest pain and quality of life in some patients, a number of key outcomes did not differ significantly -- namely, subsequent heart attack, hospitalization for unstable chest pain or heart failure, resuscitation after cardiac arrest and death from cardiovascular causes.

虽然发现侵入性手术可以改善一些患者的胸痛和生活质量，但一些关键结果并没有显著差异-即随后的心脏病发作、因不稳定的胸痛或心力衰竭而住院、心脏骤停后的复苏和心血管疾病引起的死亡。

"Patients want to know, is this treatment going to make me live longer?" said study chair Dr. Judith Hochman, senior associate dean for clinical sciences at NYU Langone Health. "Based on what we saw, we did not see evidence that would make them live longer."

“病人想知道，这种治疗是否会让我活得更长？”研究主席朱迪恩郝赤曼博士说，他是纽约大学朗格尼健康学院负责临床科学的高级副院长。“根据我们看到的情况，我们没有看到能让他们活得更长的证据。”

Stents and bypass surgeries are commonly used for patients with heart attack, but whether to intervene with patients who are stable -- who have blockages or chest pain during exercise, but not an acute heart attack -- has been hotly debated.

支架和搭桥手术通常用于心脏病发作的患者，但是否对病情稳定的患者(在运动过程中有阻塞或胸痛，但不是急性心脏病发作)进行干预一直存在激烈的争论。

Patients having a heart attack were not included in the study, nor were other groups, including those with poor heart muscle function or those with narrowing of the heart's main coronary artery.

心脏病发作的患者不包括在这项研究中，其他那些包括心肌功能差或心脏主冠状动脉狭窄的患者也不在研究范围内。

But when it came to patients with stable heart disease, "we selected patients with a very abnormal stress test," Hochman explained. "Is it was thought that if anybody is going to benefit from an invasive strategy of stenting or bypass surgery, those were the patients that would benefit."

但是当涉及到稳定的心脏病患者时，“我们选择了压力测试非常异常的患者，”郝赤曼解释说。“人们认为，如果有人要从支架植入或搭桥手术的侵入性策略中受益，那么这些患者就会受益。”

The international trial, which launched in 2012, included more than 5,000 patients in 37 countries, making it the largest study of its kind, the researchers said. Hochman said it builds on two earlier studies that made similar conclusions but, in part due to how they were designed, failed to gain wider acceptance among doctors.

研究人员表示，2012年启动的这项国际试验，涵盖了37个国家的5000多名患者，是同类研究中规模最大的一次。郝赤曼说，该研究建立在两项早期研究的基础上，这两项研究得出了类似的结论，但由于它们的设计方式，未能得到医生的广泛认可。

If asymptomatic patients forgo invasive therapies, Hochman estimates the savings could be in the hundreds of millions of dollars in the United States, based on earlier research.

郝赤曼根据早期的研究估计，如果无症状患者放弃侵入性治疗，在美国可节省数亿美元。

"The implications are quite large globally and in the United States," she said.

“其影响在全球和美国都相当大，”她说。