Meta-Analysis of Stress Myocardial Perfusion Imaging

NCT03180060 | Completed

• 1 other identifier: ABC 13-17
• Study Type: observational
• Target: 23,051
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Detection of coronary artery disease (CAD) is important due to its high prevalence and its medical and economic implications. Purpose: A systematic review of the diagnostic performance of stress echocardiography (Echo), SPECT, cardiac magnetic resonance (CMR), CT Perfusion (CTP) and PET versus invasive coronary angiography (ICA) or fractional flow reserve (FFR) using hierarchical summary ROC (HSROC) methods. Data Sources: MEDLINE, EMBASE and SCOPUS for literature published in English or Spanish from January 1970 to December 2015. Study Selection: For inclusion, studies had to meet the Cochrane guidelines, had to evaluate the sensitivity and specificity methods, and use ICA and/or FFR. Only those studies with STARD methodology ≥60% were included. Data Extraction: Ten investigators extracted patient and study characteristics and 4 resolved any disagreements.

Conditions

Coronary Disease; Echocardiography; Fractional Flow Reserve, Myocardial; Hemodynamics; Humans; Magnetic Resonance Imaging; Myocardial Perfusion Imaging; Perfusion; Predictive Value of Tests; Single Photon Emission Computed Tomography; Positron Emission Tomography; Multidetector Computed Tomography; Echocardiography, Stress; Coronary Angiography

Keywords

Likelihood Ratio; Cardiovascular Magnetic Resonance; CMR; Myocardial Perfusion; Predictive Values; Computed Tomography Perfusion; CTP; SPECT; PET; Diagnostic Accuracy; Quantitative Coronary Angiography; Area Under the Curve; ROC Curve

Outcome Measures

Primary Outcomes (1)

• Diagnostic accuracy

  To introduce scientifically strong evidence-based concepts about the greater diagnostic accuracy of newer and less widely used non-invasive imaging modalities, CMR, CTP and PET, and to emphasize that some of them are even more harmless than the older and more commonly used methods such as SPECT and Stress. Echo.

  Period comprise between 1970 up to the end of 2015.

Secondary Outcomes (2)

• Change the current worldwide idea

  Period comprise between 1970 up to the end of 2015.

• Modification of the concept that the newer non-invasive imaging modalities are not far more expensive than the older ones.

  Period comprise between 1970 up to the end of 2015.

Study Arms (5)

SPECT

SPECT compared versus four reference standards (two anatomic cutoffs: angiographic lesions \>50% and \>70% and two functional cutoffs: FFRi \<0.80 and \<0.75).

Stress Echo

Stress Echo compared versus four reference standards (two anatomic cutoffs: angiographic lesions \>50% and \>70% and two functional cutoffs: FFRi \<0.80 and \<0.75).

CMR perfusion

CMR perfusion compared versus four reference standards (two anatomic cutoffs: angiographic lesions \>50% and \>70% and two functional cutoffs: FFRi \<0.80 and \<0.75).

CT perfusion

CT perfusion compared versus four reference standards (two anatomic cutoffs: angiographic lesions \>50% and \>70% and two functional cutoffs: FFRi \<0.80 and \<0.75).

Positron Emission Tomography

PET compared versus four reference standards (two anatomic cutoffs: angiographic lesions \>50% and \>70% and two functional cutoffs: FFRi \<0.80 and \<0.75).

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

We searched all literature in English and Spanish from January 1970 to December 2015 that meet the inclusion criteria.

You may qualify if:

• All studies (prospective, retrospective and even case series) that included patients of any age and gender with known or suspected coronary artery disease and evaluated the sensitivity and specificity of SE, SPECT, CMR, CTP and PET compared with ICA and/or FFR, and to that met the Cochrane guidelines including a score of \>60% with STARD methodology.

You may not qualify if:

• Studies that included patients with known previous myocardial infarction, previous PCI with or without stent implantation, previous cardiac bypass surgery, heart transplantation, and the absence of invasive coronary angiography as a gold standard.

Sponsors & Collaborators

• American British Cowdray Medical Center: lead

Study Sites (1)

American British Cowdray Medical Center

Mexico City, 05300, Mexico

Location

Related Publications (19)

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MeSH Terms

Conditions

Coronary Disease

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases

Study Officials

• Lilia M Sierra-Galan, MD, MCvT

  American British Cowdray Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lilia M. Sierra-Galan, MD, MCvT, FACC, FSCCT

Study Record Dates

• First Submitted: June 6, 2017
• First Posted: June 8, 2017
• Study Start: August 3, 2015
• Primary Completion: June 30, 2016
• Study Completion: June 30, 2016
• Last Updated: June 8, 2017

Record last verified: 2017-06

Data Sharing

• IPD Sharing: Will share

Locations

ME (1)