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

Natasha Corballis, Vasiliki Tsampasian, Ioannis Merinopoulis, Tharusha Gunawardena, Raam Bhalraam, Simon Eccleshall, Marc R. Dweck, Vassilios Vassiliou

Research output: Contribution to journalReview articlepeer-review

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.
Original languageEnglish
Pages (from-to)207-213
Number of pages7
JournalHeart & Lung
Volume57
Early online date17 Oct 2022
DOIs
Publication statusE-pub ahead of print - 17 Oct 2022

Keywords

  • Angina
  • CTCA
  • Invasive angiography
  • Stable coronary disease

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