CT angiography compared to invasive angiography for stable coronary disease as predictors of Major Adverse Cardiovascular Events- a systematic review and meta-analysis

Corballis, Natasha, Tsampasian, Vasiliki, Merinopoulis, Ioannis, Gunawardena, Tharusha, Bhalraam, Raam, Eccleshall, Simon, Dweck, Marc R. and Vassiliou, Vassilios ORCID: https://orcid.org/0000-0002-4005-7752 (2023) CT angiography compared to invasive angiography for stable coronary disease as predictors of Major Adverse Cardiovascular Events- a systematic review and meta-analysis. Heart & Lung, 57. pp. 207-213. ISSN 0147-9563

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Abstract

Background: Computational tomography coronary angiography (CTCA) is increasingly the diagnostic test of choice for investigating patients with stable anginal symptoms. Objectives: 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. Methods: 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. Results: 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%]. Conclusion: CTCA is a safe strategy for investigating patients with stable angina with no associated increase in MACE but a reduction in revascularisation rates.

Item Type: Article
Additional Information: Funding Information: Dr Natasha Corballis and Dr Vasiliki Tsampasian are NIHR Academic Clinical Fellows. Dr Simon Eccleshall received funding for lectures and proctorship from B Braun, Medtronic and MedAlliance and funding for investigator-initiated research unrelated to this work from B Braun. Professor Dweck MRD is supported by the British Heart Foundation (FS/14/78/31020) and is the recipient of a Sir Jules Thorn Award for Biomedical Research 2015 (15/JTA). Professor Vassiliou receives funding for investigator initiated research unrelated to this work from B Braun and Medtronic. This work was partially supported by the Norfolk Heart Trust.
Uncontrolled Keywords: angina,ctca,invasive angiography,stable coronary disease,pulmonary and respiratory medicine,critical care and intensive care medicine,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2740
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 29 Sep 2022 10:30
Last Modified: 19 Oct 2023 03:26
URI: https://ueaeprints.uea.ac.uk/id/eprint/88717
DOI: 10.1016/j.hrtlng.2022.09.018

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