Titre
Atherosclerosis screening by noninvasive imaging for cardiovascular prevention: a systematic review.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Rodondi, N.
Auteure/Auteur
Auer, R.
Auteure/Auteur
de Bosset Sulzer, V.
Auteure/Auteur
Ghali, W.A.
Auteure/Auteur
Cornuz, J.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0884-8734
Statut éditorial
Publié
Date de publication
2012
Volume
27
Numéro
2
Première page
220
Dernière page/numéro d’article
231
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review Publication Status: ppublish
Résumé
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.
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.
PID Serval
serval:BIB_F3301468964E
PMID
Open Access
Oui
Date de création
2012-01-30T15:29:52.787Z
Date de création dans IRIS
2025-05-21T06:46:07Z
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REF.pdf
Version du manuscrit
published
Taille
230.53 KB
Format
Adobe PDF
PID Serval
serval:BIB_F3301468964E.P001
URN
urn:nbn:ch:serval-BIB_F3301468964E7
Somme de contrôle
(MD5):337464fc5efe323f4abd96e9f2e626e8