BACKGROUND: 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.
BACKGROUND: 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.
Authors: Seamus P Whelton; Khurram Nasir; Michael J Blaha; Heidi Gransar; Thomas S Metkus; Josef Coresh; Daniel S Berman; Roger S Blumenthal Journal: Circ Cardiovasc Qual Outcomes Date: 2012-07-01
Authors: Walter T Ambrosius; Tamar S Polonsky; Philip Greenland; David C Goff; Letitia H Perdue; Stephen P Fortmann; Karen L Margolis; Nicholas M Pajewski Journal: Clin Trials Date: 2012-02-14 Impact factor: 2.486
Authors: Francesca Mantovani; Sahar S Abdelmoneim; Victoria Zysek; Susan Eifert-Rain; Sharon L Mulvagh Journal: J Womens Health (Larchmt) Date: 2014-06-16 Impact factor: 2.681
Authors: Joshua R Lewis; Mandy Stanley; Reindolf Anokye; Ben Jackson; James Dimmock; Joanne M Dickson; Lauren C Blekkenhorst; Jonathan M Hodgson Journal: F1000Res Date: 2020-11-26