Diagnostic Performance of CMR, SPECT, and PET Imaging for the Identification of Coronary Artery Disease: A Meta-Analysis

Background: Myocardial perfusion imaging modalities, such as cardiac magnetic resonance (CMR), single-photon emission computed tomography (SPECT), and positron emission tomography (PET), are well-established non-invasive diagnostic methods to detect hemodynamically significant coronary artery disease (CAD). The aim of this meta-analysis is to compare CMR, SPECT, and PET in the diagnosis of CAD and to provide evidence for further research and clinical decision-making.Methods: PubMed, Web of Science, EMBASE, and Cochrane Library were searched. Studies that used CMR, SPECT, and/or PET for the diagnosis of CAD were included. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio with their respective 95% confidence interval, and the area under the summary receiver operating characteristic (SROC) curve were calculated.Results: A total of 203 articles were identified for inclusion in this meta-analysis. The pooled sensitivity values of CMR, SPECT, and PET were 0.86, 0.83, and 0.85, respectively. Their respective overall specificity values were 0.83, 0.77, and 0.86. Results in subgroup analysis of the performance of SPECT with 201Tl showed the highest pooled sensitivity [0.85 (0.82, 0.88)] and specificity [0.80 (0.75, 0.83)]. 99mTc-tetrofosmin had the lowest sensitivity [0.76 (0.67, 0.82)]. In the subgroup analysis of PET tracers, results indicated that 13N had the lowest pooled sensitivity [0.83 (0.74, 0.89)], and the specificity was the highest [0.91 (0.81, 0.96)].Conclusion: Our meta-analysis indicates that CMR and PET present better diagnostic performance for the detection of CAD as compared with SPECT.

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Diagnostic performance of wireless fractional flow reserve: a meta-analysis

Archives of Medical Science ◽

10.5114/aoms/117960 ◽

2021 ◽

Author(s):

Wen Pan ◽

Qing-Jun Liu

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Likelihood Ratio ◽

Fractional Flow Reserve ◽

Diagnostic Performance ◽

Meta Analysis ◽

Fractional Flow ◽

Flow Reserve ◽

Artery Disease ◽

Sensitivity Specificity

IntroductionThe aim of this study was to evaluate diagnostic performance of wireless fractional flow reserve (FFR) used in patients with coronary artery disease (CAD).Material and methodsPubMed, Cochrane Library, Embase and Clinical trial.gov databases were searched by computer search and manual retrieval. The search terms included fractional flow reserve, quantitative coronary angiography, computational fluid dynamics and coronary artery disease. The meta-analysis was conducted with Stata12.0. Clinical outcomes included accuracy, sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (–LR), diagnostic odds ratio (DOR) and area under the receiver operating curve.ResultsNine studies comprising 2052 vessels were included in the present meta-analysis. The sensitivity, specificity, +LR, –LR, DOC and accuracy were 87% (95% CI: 83–94%), 88% (95% CI: 82–92%), 7.28 (95% CI: 4.78–11.08), 0.14 (95% CI: 0.10–0.21), 50.69 (95% CI: 25.22–101.88) and 0.94 (95% CI: 0.91–0.96) respectively. No significant publication bias was detected.ConclusionsThis meta-analysis suggests that the clinical performance such as accuracy, sensitivity and specificity of wireless FFR is good to detect stenotic lesions with pressure-wire measured FFR as a reference.

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Sarcopenia predicts adverse outcomes in an elderly population with coronary artery disease: a systematic review and meta-analysis

BMC Geriatrics ◽

10.1186/s12877-021-02438-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qiqi Xue ◽

Jie Wu ◽

Yan Ren ◽

Jiaan Hu ◽

Ke Yang ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Meta Analysis ◽

Psoas Muscle ◽

Coronary Intervention ◽

Adverse Outcomes ◽

Cochrane Library ◽

Muscle Area ◽

Area Index ◽

Artery Disease

Abstract Background The development of sarcopenia is attributed to normal aging and factors like type 2 diabetes, obesity, inactivity, reduced testosterone levels, and malnutrition, which are factors of poor prognosis in patients with coronary artery disease (CAD). This study aimed to perform a meta-analysis to assess whether preoperative sarcopenia can be used to predict the outcomes after cardiac surgery in elderly patients with CAD. Methods PubMed, Embase, the Cochrane library, and Web of Science were searched for available papers published up to December 2020. The primary outcome was major adverse cardiovascular outcomes (MACE). The secondary outcomes were mortality and heart failure (HF)-related hospitalization. The random-effects model was used. Hazard ratios (HRs) with 95% confidence intervals (95%CIs) were estimated. Results Ten studies were included, with 3707 patients followed for 6 months to 4.5 ± 2.3 years. The sarcopenia population had a higher rate of MACE compared to the non-sarcopenia population (HR = 2.27, 95%CI: 1.58–3.27, P < 0.001; I2 = 60.0%, Pheterogeneity = 0.02). The association between sarcopenia and MACE was significant when using the psoas muscle area index (PMI) to define sarcopenia (HR = 2.86, 95%CI: 1.84–4.46, P < 0.001; I2 = 0%, Pheterogeneity = 0.604). Sarcopenia was not associated with higher late mortality (HR = 2.15, 95%CI: 0.89–5.22, P = 0.090; I2 = 91.0%, Pheterogeneity < 0.001), all-cause mortality (HR = 1.35, 95%CI: 0.14–12.84, P = 0.792; I2 = 90.5%, Pheterogeneity = 0.001), and death, HF-related hospitalization (HR = 1.37, 95%CI: 0.59–3.16, P = 0.459; I2 = 62.0%, Pheterogeneity = 0.105). The sensitivity analysis revealed no outlying study in the analysis of the association between sarcopenia and MACE after coronary intervention. Conclusion Sarcopenia is associated with poor MACE outcomes in patients with CAD. The results could help determine subpopulations of patients needing special monitoring after CAD surgery. The present study included several kinds of participants; although non-heterogeneity was found, interpretation should be cautious.

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