OBJECTIVES: Despite extensive use in practice, the impact of noninvasive cardiovascular imaging in primary prevention remains unclear.
METHODS: We searched for 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.
RESULTS: 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 (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.76-1.33) or on provision of lipid-modifying agents (OR, 1.08; 95% CI, 0.58-2.01), antihypertensive drugs (OR, 1.05; 95% CI, 0.75-1.47), or antiplatelet agents (OR, 1.05; 95% CI, 0.84-1.32). Similarly, no effect was seen on dietary improvement (OR, 0.78; 95% CI, 0.22-2.85), physical activity (0.02 vs -0.08 point change for imaging vs control on a 5-point scale; P = .23), or smoking cessation (OR, 2.24; 95% CI, 0.97-5.19). Imaging was not associated with invasive angiography (OR, 1.26; 95% CI, 0.89-1.79).
CONCLUSIONS: 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.
Lady Davis Carmel Medical Center
Latest posts by Ronen Rubinshtein (see all)
- Anatomic Characteristics and Outcome of Adults With Coronary Arteries Arising From an Anomalous Location Detected With Coronary Computed Tomography Angiography - October 2, 2014
- Fractional Flow Reserve Calculation From 3-Dimensional Quantitative Coronary Angiography and TIMI Frame Count: A Fast Computer Model to Quantify the Functional Significance of Moderately Obstructed Coronary Arteries - September 4, 2014
- Iterative Model Reconstruction: Improved Image Quality of Low-Tube-Voltage Prospective ECG-Gated Coronary CT Angiography Images at 256-Slice CT - June 1, 2014