Prognostic Value of Myocardial Perfusion Analysis in Patients with Coronary Artery Disease

A Meta-Analysis

Jiancheng Xiu, Kai Cui, Yuegang Wang, Hua Zheng, Gangbin Chen, Qian Feng, Jianping Bin, Juefei Wu, Thomas Richard Porter

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Myocardial perfusion (MP) imaging during stress myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic value to predict cardiac events in patients with known or suspected CAD is still undefined. Methods: A search was conducted for single- or multicenter prospective studies that evaluated the prognostic value of stress MCE in patients with known or suspected CAD. A database search was performed through June 2015. Effect sizes of relative risk ratios (RRs) with their corresponding 95% CIs were used to evaluate the association between the occurrence of total cardiac events (cardiac death, nonfatal myocardial infarction, coronary revascularization) and hard cardiac events (cardiac death and nonfatal myocardial infarction) in subjects with normal and abnormal MP measured by MCE. The Cochran Q statistic and the I 2 statistic were used to assess heterogeneity. Results: A comprehensive literature search of the MEDLINE, Google Scholar, Cochrane, and Embase databases identified 11 studies enrolling a total of 4,045 patients. The overall analysis of RRs revealed that patients with abnormal MP were at higher risk for total cardiac events compared with patients with normal MP (RR, 5.58; 95% CI, 3.64-8.57; P < .001), with low heterogeneity among trials (I 2 = 48.15%, Q = 7.71, P = .103). Similarly, patients with abnormal MP were at higher risk for hard cardiac events compared with patients with normal MP (RR, 4.99; 95% CI, 1.75-14.32; P = .003), with significant heterogeneity among trials (I 2 = 81.48%, Q = 21.59, P < .001). Conclusions: The results of this meta-analysis suggest that MP assessment using stress MCE is an effective prognostic tool for predicting the occurrence of cardiac events in patients with known or suspected CAD.

Original languageEnglish (US)
JournalJournal of the American Society of Echocardiography
DOIs
StateAccepted/In press - 2016

Fingerprint

Meta-Analysis
Coronary Artery Disease
Perfusion
Echocardiography
Odds Ratio
Myocardial Infarction
Databases
Myocardial Perfusion Imaging
MEDLINE
Multicenter Studies
Prospective Studies

Keywords

  • Coronary artery disease
  • Myocardial contrast echocardiography
  • Myocardial perfusion
  • Prognosis
  • Stress echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic Value of Myocardial Perfusion Analysis in Patients with Coronary Artery Disease : A Meta-Analysis. / Xiu, Jiancheng; Cui, Kai; Wang, Yuegang; Zheng, Hua; Chen, Gangbin; Feng, Qian; Bin, Jianping; Wu, Juefei; Porter, Thomas Richard.

In: Journal of the American Society of Echocardiography, 2016.

Research output: Contribution to journalArticle

Xiu, Jiancheng ; Cui, Kai ; Wang, Yuegang ; Zheng, Hua ; Chen, Gangbin ; Feng, Qian ; Bin, Jianping ; Wu, Juefei ; Porter, Thomas Richard. / Prognostic Value of Myocardial Perfusion Analysis in Patients with Coronary Artery Disease : A Meta-Analysis. In: Journal of the American Society of Echocardiography. 2016.
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abstract = "Background: Myocardial perfusion (MP) imaging during stress myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic value to predict cardiac events in patients with known or suspected CAD is still undefined. Methods: A search was conducted for single- or multicenter prospective studies that evaluated the prognostic value of stress MCE in patients with known or suspected CAD. A database search was performed through June 2015. Effect sizes of relative risk ratios (RRs) with their corresponding 95{\%} CIs were used to evaluate the association between the occurrence of total cardiac events (cardiac death, nonfatal myocardial infarction, coronary revascularization) and hard cardiac events (cardiac death and nonfatal myocardial infarction) in subjects with normal and abnormal MP measured by MCE. The Cochran Q statistic and the I 2 statistic were used to assess heterogeneity. Results: A comprehensive literature search of the MEDLINE, Google Scholar, Cochrane, and Embase databases identified 11 studies enrolling a total of 4,045 patients. The overall analysis of RRs revealed that patients with abnormal MP were at higher risk for total cardiac events compared with patients with normal MP (RR, 5.58; 95{\%} CI, 3.64-8.57; P < .001), with low heterogeneity among trials (I 2 = 48.15{\%}, Q = 7.71, P = .103). Similarly, patients with abnormal MP were at higher risk for hard cardiac events compared with patients with normal MP (RR, 4.99; 95{\%} CI, 1.75-14.32; P = .003), with significant heterogeneity among trials (I 2 = 81.48{\%}, Q = 21.59, P < .001). Conclusions: The results of this meta-analysis suggest that MP assessment using stress MCE is an effective prognostic tool for predicting the occurrence of cardiac events in patients with known or suspected CAD.",
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AU - Cui, Kai

AU - Wang, Yuegang

AU - Zheng, Hua

AU - Chen, Gangbin

AU - Feng, Qian

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AB - Background: Myocardial perfusion (MP) imaging during stress myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic value to predict cardiac events in patients with known or suspected CAD is still undefined. Methods: A search was conducted for single- or multicenter prospective studies that evaluated the prognostic value of stress MCE in patients with known or suspected CAD. A database search was performed through June 2015. Effect sizes of relative risk ratios (RRs) with their corresponding 95% CIs were used to evaluate the association between the occurrence of total cardiac events (cardiac death, nonfatal myocardial infarction, coronary revascularization) and hard cardiac events (cardiac death and nonfatal myocardial infarction) in subjects with normal and abnormal MP measured by MCE. The Cochran Q statistic and the I 2 statistic were used to assess heterogeneity. Results: A comprehensive literature search of the MEDLINE, Google Scholar, Cochrane, and Embase databases identified 11 studies enrolling a total of 4,045 patients. The overall analysis of RRs revealed that patients with abnormal MP were at higher risk for total cardiac events compared with patients with normal MP (RR, 5.58; 95% CI, 3.64-8.57; P < .001), with low heterogeneity among trials (I 2 = 48.15%, Q = 7.71, P = .103). Similarly, patients with abnormal MP were at higher risk for hard cardiac events compared with patients with normal MP (RR, 4.99; 95% CI, 1.75-14.32; P = .003), with significant heterogeneity among trials (I 2 = 81.48%, Q = 21.59, P < .001). Conclusions: The results of this meta-analysis suggest that MP assessment using stress MCE is an effective prognostic tool for predicting the occurrence of cardiac events in patients with known or suspected CAD.

KW - Coronary artery disease

KW - Myocardial contrast echocardiography

KW - Myocardial perfusion

KW - Prognosis

KW - Stress echocardiography

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