计算断层摄影冠状动脉造影(CTCA)越来越成为调查具有稳定心绞痛症状的患者的首选诊断测试。
我们试图进行系统评价和荟萃分析,比较CTCA和侵入性冠状动脉造影(ICA)对主要不良心血管事件(MACE)的影响。手术并发症和血运重建率。
我们根据PRISMA声明进行了系统评价和荟萃分析。使用PubMed进行了文献检索,MEDLINEOvid和Embase,三项研究纳入荟萃分析。使用ReviewManager5.3forMacOS软件进行统计分析,结果以比值比表示,进行95%置信区间和敏感性分析.
共有5662名患者被纳入本研究水平的荟萃分析。CT与血管造影MACE无差异[2.97%v3.45%,固定效应模型,OR:0.84(0.62-1.14),p=0.26,I20%],心肌梗死发生率无差异,死亡或中风。CTCA与血运重建率降低相关[12.6%v18.3%,固定效应模型,OR:0.64(0.55-0.75),p<0.00001,I2=0%]。然而,CTCA与显著较低的并发症发生率无关[0.5%v1.72%,随机效应模型,OR:0.52(0.06-4.38),p=0.55,I252%]。
CTCA是研究稳定型心绞痛患者的一种安全的策略,MACE没有增加,但血运重建率降低。
Computational tomography coronary angiography (CTCA) is increasingly the diagnostic test of choice for investigating patients with stable anginal symptoms.
We sought to conduct a systematic review and meta-analysis comparing CTCA with invasive coronary angiography (ICA) with regards to major adverse cardiovascular events (MACE), procedural complications and rates of revascularisation.
We conducted a systematic review and meta-analysis in line with the PRISMA statement. A literature search was conducted using PubMed, MEDLINE Ovid and Embase, with three studies included in meta-analysis. Statistical analysis was undertaken using Review Manager 5.3 for MacOS software and outcomes expressed as odds ratio, with 95% confidence intervals and sensitivity analysis was conducted.
A total of 5662 patients were included in this study level meta-analysis. There was no difference in MACE between CT and angiography [2.97% v 3.45%, fixed-effect model, OR: 0.84 (0.62-1.14), p = 0.26, I2 0%] and no difference found in rates of myocardial infarction, death or stroke. CTCA was associated with a reduced rate of revascularisation [12.6% v 18.3%, fixed-effects model, OR: 0.64 (0.55-0.75), p<0.00001, I2 =0%]. However, CTCA was not associated with a significantly lower complication rate [0.5% v 1.72%, random effects model, OR: 0.52 (0.06-4.38), p = 0.55, I2 52%].
CTCA is a safe strategy for investigating patients with stable angina with no associated increase in MACE but a reduction in revascularisation rates.