虚假阳性应激心声回应的预后相关性:系统性审查和元分析
Sadie Bennett1,2, Prenali Dwisthi Sattwika3, Jacopo Tafuro1
1Heart & Lung Clinic, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.
假阳性压力回声图在怀疑缺血性心脏病的患者中很常见. 这些结果与真正的阳性相比,并没有增加主要的不良心血管事件,但需要更多的研究来与真正的负面进行比较.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 临床研究 临床研究
背景情况:
- 压力心声图是评估缺血性心脏病 (IHD) 和手术风险的关键工具.
- 虚假阳性 (FP) 应激心电图的预后意义仍然不清楚,尽管在阳性测试中,主要不良心血管事件 (MACE) 发生率较高.
研究的目的:
- 为了评估虚假阳性 (FP) 应激心声图结果的预后相关性,应用于疑似或已知的缺血性心脏病 (IHD) 患者.
主要方法:
- 在主要数据库 (Medline,Embase等) 进行了系统的文献搜索. 在2024年4月之前.
- 包括的研究评估了FP压力心电图在IHD患者的预后相关性.
- 随机效应元分析比较了FP,真正阳性和真负结果之间的MACE率.
主要成果:
- 分析了5项涉及2426名患者的研究;30.3%的FP结果.
- 在FP组中,MACE发生在28.8%的患者中.
- 分析显示,与真正阳性结果相比,FP中的MACE较少 (RR 1.64),但与真负结果进行比较的证据不足.
结论:
- 错误的阳性应力回声心电图是常见的,特别是在前测试IHD概率较低的患者中.
- 与真实阳性相比,FP结果与MACE增加无关.
- 需要更多的证据来确定FP结果是否能识别高风险患者与真正的负面患者.
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