Noninvasive cardiovascular imaging in primary prevention

January 01, 0001

Noninvasive cardiovascular imaging in primary prevention

These authors from multiple countries conducted a meta- analysis of randomized trials that compared imaging with usual care and reported any of the following outcomes in a primary prevention setting: medication prescribing, lifestyle modification (including diet, exercise, or smoking cessation), angiography, or revascularization.

They found: "Seven trials were included. Trials screened patients for inducible myocardial ischemia (2 trials), coronary calcification (3 trials), carotid atherosclerosis (1 trial), or left ventricular hypertrophy (1 trial). Imaging had no effect on medication prescribing overall (OR, 1.01) or on provision of lipid-modifying agents (OR, 1.08), antihypertensive drugs (OR, 1.05), or antiplatelet agents (OR, 1.05). Similarly, no effect was seen on dietary improvement (OR, 0.78), physical activity (0.02 vs -0.08 point change for imaging vs control on a 5-point scale), or smoking cessation (OR, 2.24). Imaging was not associated with invasive angiography (OR, 1.26)."

The authors concluded: "We found limited evidence suggesting that noninvasive cardiovascular imaging alters primary prevention efforts. However, given the imprecision of these results, further high-quality studies are needed."

Wide-spread screening efforts using such technologies should wait for evidence that shows benefit.

For the full abstract, click here.

Arch Intern Med 171(11):977-982, 13 June 2011 © 2011 to the American Medical Association
Influence of Noninvasive Cardiovascular Imaging in Primary Prevention-Systematic Review and Meta-analysis of Randomized Trials. Daniel G. Hackam, Kaveh G. Shojania, J. David Spence, et al. Correspondence to Dr. Hackam: [email protected]

Category: K. Circulatory. Keywords: imaging, primary prevention, cardiovascular prevention, meta- analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 28 June 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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