Comparison of the prognostic value of negative non-invasive cardiac investigations in patients with suspected or known coronary artery disease–a meta-analysis

Abstract Aims To compare the prognostic value of negative non-invasive cardiac investigations (coronary computed tomographic angiography [CCTA], cardiovascular magnetic resonance [CMR], exercise electrocardiographic testing [EET], positron emission tomography [PET], stress-echocardiography [SE], and...

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Bibliographic Details
Published in:European heart journal cardiovascular imaging 2017-09, Vol.18 (9), p.980-987
Main Authors: Smulders, Martijn W., Jaarsma, Caroline, Nelemans, Patricia J., Bekkers, Sebastiaan C.A.M., Bucerius, Jan, Leiner, Tim, Crijns, Harry J.G.M., Wildberger, Joachim E., Schalla, Simon
Format: Article
Language:English
Subjects:
Aged
Asymptomatic Diseases
Cardiac Imaging Techniques - methods
Computed Tomography Angiography - methods
Coronary Angiography - methods
Coronary Artery Disease - complications
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Disease Progression
Echocardiography, Stress - methods
Female
Humans
Magnetic Resonance Imaging, Cine - methods
Male
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - mortality
Positron-Emission Tomography - methods
Prognosis
Severity of Illness Index
Tomography, Emission-Computed, Single-Photon - methods
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Summary:Abstract Aims To compare the prognostic value of negative non-invasive cardiac investigations (coronary computed tomographic angiography [CCTA], cardiovascular magnetic resonance [CMR], exercise electrocardiographic testing [EET], positron emission tomography [PET], stress-echocardiography [SE], and single-photon emission tomography [SPECT]) in patients with suspected or known coronary artery disease (CAD) and to explore the effect of adjustment for population event risk and presence of CAD. Methods and results MEDLINE/PubMed database, EMBASE and Cochrane Library were searched from January-1990 to April-2015 for studies reporting annual event rates (AER) of myocardial infarction (MI) and cardiac death. Pooled estimates of AERs were calculated using a DerSimonian and Laird random-effects model. Multivariable linear meta-regression analysis was performed to compare the AER after a negative test result between modalities and to adjust for population event risk and proportion of patients with CAD. In 165 studies (122,721 patients), pooled AERs after negative test results differed significantly between modalities ranging from 0.32% for CCTA to 1.66% for SE, P 
ISSN:2047-2404
2047-2412
DOI:10.1093/ehjci/jex014