TY - JOUR
T1 - Prognostic value of resting myocardial contrast echocardiography
T2 - A meta-analysis
AU - Qian, Lijun
AU - Xie, Feng
AU - Xu, Di
AU - Porter, Thomas R.
N1 - Funding Information:
This study was partially supported by the National Natural Science Foundation of China (Grant No. 81871359), by Jiangsu Provincial Key Discipline of Medicine (ZDXKA2016003), by the Natural Science Foundation of Jiangsu Province (BK20161057), by the Postgraduate Research & Practice Innovation Program of Jiangsu Province (KYCX18_1478) and the China Scholarship Council (201808320318). This was also supported by the Theodore F Hubbard Foundation at the University of Nebraska Medical Center. The authors thank Alyssa Elwood for her administrative assistance with this manuscript.
Funding Information:
This study was partially supported by the National Natural Science Foundation of China (Grant No. 81871359), by Jiangsu Provincial Key Discipline of Medicine (ZDXKA2016003), by the Natural Science Foundation of Jiangsu Province (BK20161057), by the Postgraduate Research & Practice 阀nnovation Program of Jiangsu Province (KYCX18_1478) and the China Scholarship Council (201808320318). This was also supported by the Theodore F Hubbard Foundation at the University of Nebraska Medical Center.
PY - 2020
Y1 - 2020
N2 - Background: Resting myocardial perfusion (MP) and wall motion (WM) imaging during real-time myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic role in different clinical settings (emergency department and outpatient setting) remains unclear. Methods: A systematic search in PubMed and Embase databases, and the Cochrane library, was conducted to evaluate the role of resting MP and WM in predicting major adverse cardiac events (MACE), including death, nonfatal myocardial infarction (NFMI) and urgent revascularization in patients presenting to either outpatient clinics or emergency departments with suspected symptomatic CAD. Summary receiver operating characteristic (SROC) curves, sensitivity and specificity plots were applied to assess diagnostic performance using RevMan 5.3. Results: Seven studies met criteria, including 3668 patients (six with follow up ranging from 2 days to 2.6 years). The Relative Risk (RR) for predicting MACE in patients with both abnormal resting MP and WM was 6.1 (95% CI, 5.1–7.2) and 14.3 (95% CI, 10.3–19.8) for death/NFMI, when compared to normal resting MP and WM patients. Having both abnormal resting MP and WM was also more predictive of MACE (RR, 1.7; 95% CI 1.5–1.9) and death/NFMI (RR, 2.2; 95% CI, 1.8–2.7) when compared to abnormal WM with normal resting MP. Conclusion: In this meta-analysis of both ED and outpatient clinic presentations for suspected CAD, having both a resting regional MP and WM abnormality identifies the highest risk patient for adverse events.
AB - Background: Resting myocardial perfusion (MP) and wall motion (WM) imaging during real-time myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic role in different clinical settings (emergency department and outpatient setting) remains unclear. Methods: A systematic search in PubMed and Embase databases, and the Cochrane library, was conducted to evaluate the role of resting MP and WM in predicting major adverse cardiac events (MACE), including death, nonfatal myocardial infarction (NFMI) and urgent revascularization in patients presenting to either outpatient clinics or emergency departments with suspected symptomatic CAD. Summary receiver operating characteristic (SROC) curves, sensitivity and specificity plots were applied to assess diagnostic performance using RevMan 5.3. Results: Seven studies met criteria, including 3668 patients (six with follow up ranging from 2 days to 2.6 years). The Relative Risk (RR) for predicting MACE in patients with both abnormal resting MP and WM was 6.1 (95% CI, 5.1–7.2) and 14.3 (95% CI, 10.3–19.8) for death/NFMI, when compared to normal resting MP and WM patients. Having both abnormal resting MP and WM was also more predictive of MACE (RR, 1.7; 95% CI 1.5–1.9) and death/NFMI (RR, 2.2; 95% CI, 1.8–2.7) when compared to abnormal WM with normal resting MP. Conclusion: In this meta-analysis of both ED and outpatient clinic presentations for suspected CAD, having both a resting regional MP and WM abnormality identifies the highest risk patient for adverse events.
KW - Coronary artery disease
KW - Myocardial contrast echocardiography
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85090926200&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090926200&partnerID=8YFLogxK
U2 - 10.1530/ERP-20-0023
DO - 10.1530/ERP-20-0023
M3 - Article
C2 - 32698153
AN - SCOPUS:85090926200
VL - 7
SP - 19
EP - 38
JO - Echo Research and Practice
JF - Echo Research and Practice
SN - 2055-0464
IS - 3
ER -