胸痛影像学评估的前瞻性多中心研究及进展

胸痛评估的前瞻性多中心影像学研究（PROMISE）始于2010年，该研究分析症状稳定的疑似冠心病病人首选冠状动脉CT血管成像（CCTA）进行解剖学检查或首选无创性功能学检查，旨在探究病人临床结局的差异。PROMISE研究了CCTA、功能学检查及冠状动脉钙化积分和CT血流储备分数等无创性检查方法对疑似冠心病的稳定性胸痛病人的预后价值，并探讨了生物标志物、年龄、性别、代谢性疾病对稳定性胸痛病人的影响。此外，PROMISE开发并验证了风险分层模型和个体化选择检查方法的工具。PROMISE对CCTA和功能学检查的应用产生了很大的影响，为疑似冠心病病人无创检查方法的选择提供了重要循证依据。

The prospective multicenter study and its progression for imaging evaluation of chest pain

The prospective multicenter imaging study for evaluation of chest pain (PROMISE) was initiated in 2010. The main purpose was to compare the difference in clinical outcomes between symptomatic stable patients with suspected coronary heart disease who performed anatomical coronary CT angiography (CCTA) diagnostic strategy and who performed functional diagnostic strategy. PROMISE studied the prognostic value of noninvasive methods such as CCTA, functional tests, coronary artery calcification score and CT-derived fractional flow reserve in patients with stable chest pain and suspected coronary heart disease. The effects of biomarkers, age, gender and metabolic diseases on the patients were also studied. In addition, PROMISE developed and validated models for risk stratification and tools for individualized selection of imaging methods. PROMISE has a great impact on the application of CCTA and functional tests, it provides an important evidence based basis for the selection of noninvasive methods for the patients with suspected coronary heart disease.