Atherosclerosis screening by noninvasive imaging for cardiovascular prevention: a systematic review.

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Serval ID
serval:BIB_F3301468964E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Atherosclerosis screening by noninvasive imaging for cardiovascular prevention: a systematic review.
Journal
Journal of General Internal Medicine
Author(s)
Rodondi N., Auer R., de Bosset Sulzer V., Ghali W.A., Cornuz J.
ISSN
0884-8734
ISSN-L
1525-1497 (Electronic)
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
27
Number
2
Pages
220-231
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review Publication Status: ppublish
Abstract
BACKGROUND: Noninvasive imaging of atherosclerosis is being increasingly used in clinical practice, with some experts recommending to screen all healthy adults for atherosclerosis and some jurisdictions mandating insurance coverage for atherosclerosis screening. Data on the impact of such screening have not been systematically synthesized.
OBJECTIVES: We aimed to assess whether atherosclerosis screening improves cardiovascular risk factors (CVRF) and clinical outcomes.
DESIGN: This study is a systematic review.
DATA SOURCES: We searched MEDLINE and the Cochrane Clinical Trial Register without language restrictions.
STUDY ELIGIBILITY CRITERIA: We included studies examining the impact of atherosclerosis screening with noninvasive imaging (e.g., carotid ultrasound, coronary calcification) on CVRF, cardiovascular events, or mortality in adults without cardiovascular disease.
RESULTS: We identified four randomized controlled trials (RCT, n=709) and eight non-randomized studies comparing participants with evidence of atherosclerosis on screening to those without (n=2,994). In RCTs, atherosclerosis screening did not improve CVRF, but smoking cessation rates increased (18% vs. 6%, p=0.03) in one RCT. Non-randomized studies found improvements in several intermediate outcomes, such as increased motivation to change lifestyle and increased perception of cardiovascular risk. However, such data were conflicting and limited by the lack of a randomized control group. No studies examined the impact of screening on cardiovascular events or mortality. Heterogeneity in screening methods and studied outcomes did not permit pooling of results.
CONCLUSION: Available evidence about atherosclerosis screening is limited, with mixed results on CVRF control, increased smoking cessation in one RCT, and no data on cardiovascular events. Such screening should be validated by large clinical trials before widespread use.
Keywords
Atherosclerosis/complications, Atherosclerosis/diagnosis, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/prevention & control, Clinical Trials as Topic/methods, Diagnostic Imaging/methods, Humans, Mass Screening/methods, Randomized Controlled Trials as Topic/methods
Pubmed
Web of science
Open Access
Yes
Create date
30/01/2012 17:29
Last modification date
01/10/2019 7:20
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