Comparison of prognosis between coronary computed tomography angiography versus invasive coronary angiography for stable coronary artery disease: a systematic review and meta-analysis

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Qingya Xie¹  Ruizhe Zhang¹  Pingxi Xiao²  Yuping Tang³  Lingling Zhou³  Gaoxiang Ma⁴  Ying Li⁴  Han Wei⁵ 

[1] Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China;Department of Cardiology, The Forth Affiliated Hospital, Nanjing Medical University, Nanjing, China;Department of Orthopaedic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China;State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, China;null;

关键词: coronary computed tomography angiography;    invasive coronary angiography;    stable coronary artery disease;    meta-analysis;    review;   

DOI  :  10.3389/fcvm.2023.1010536

 received in 2022-08-03, accepted in 2023-04-21,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe impact of using invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) as an initial examination on the incidence of major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease and the occurrence of major operation-related complications is uncertain.ObjectiveThis study aimed to explore the effects of ICA vs. CCTA on MACEs, all-cause death, and major operation-related complications.MethodsA systematic search of electronic databases (PubMed and Embase) was conducted for randomized controlled trials and observational studies comparing MACEs between ICA and CCTA from January 2012 to May 2022. The primary outcome measure was analyzed using a random-effects model as a pooled odds ratio (OR). The main observations were MACEs, all-cause death, and major operation-related complications.ResultsA total of six studies, comprising 26,548 patients, met the inclusion criteria (ICA n = 8,472; CCTA n = 18,076). There were statistically significant differences between ICA and CCTA for MACE [OR 1.37; 95% confidence interval (CI), 1.06–1.77; p = 0.02], all-cause death (OR 1.56; 95% CI, 1.38–1.78; p < 0.00001), and major operation-related complications (OR 2.10; 95% CI, 1.23–3.61; p = 0.007) among patients with stable coronary artery disease. Subgroup analysis demonstrated statistically significant results in the impact of ICA or CCTA on MACEs according to the length of follow-up. Compared to CCTA, ICA was related to a higher incidence of MACEs in the subgroup with a short follow-up (≤3 years) (OR 1.74; 95% CI, 1.54–1.96; p < 0.00001).ConclusionsAmong patients with stable coronary artery disease, an initial examination with ICA was significantly associated with the risk of MACEs, all-cause death, and major procedure-related complications compared to CCTA in this meta-analysis.

【 授权许可】

Unknown   
© 2023 Xie, Zhou, Li, Zhang, Wei, Ma, Tang and Xiao.