Routine stress testing in diabetic patients after coronary intervention: a systematic review and meta-analysis

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2024-12-18 DOI:10.1016/j.cpcardiol.2024.102972

Juan P. de Oliveira , Franciani R. da Rocha MSc, PhD , Ramon Huntermann , Raissa P. de Oliveira MD , Caroline O. Fischer Bacca MD

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引用次数: 0

Abstract

Background

Stress testing is a widely used non-invasive tool in patients with angina, but its role in diabetic patients after coronary intervention remains uncertain. This review evaluates its impact in this population.

Goals

We aimed to perform a systematic review and meta-analysis of studies assessing death, MACE, ischemia and repeated revascularization in diabetic patients post-coronary intervention.

Methods

We searched PubMed, Embase, and Cochrane for RCTs and cohort studies on diabetic patients post-revascularization reporting MI and cardiovascular death, ischemia, repeat revascularization, and pooled hazard ratios for mortality or MI. Statistical analysis used RStudio and RevMan, with heterogeneity assessed via I² statistics.

Results

We included 14,461 patients from 15 studies (14 observational cohorts, 1 RCT), all with diabetes and prior revascularization. Follow-up ranged from 1 to 5.2 years, with a mean age of 60.8 ± 9.5 years, and 75 % male. MI and cardiovascular death occurred in 11.24 % (95 % CI: 7.35–15.79 %; p < 0.01, Figure 2), ischemia in 36.07 % (95 % CI: 30.26–42.08 %; p < 0.01, Figure 3), and repeated revascularization in 15.65 % (95 % CI: 6.65–27.64 %; p < 0.01, Figure 4). For mortality or MI, the pooled hazard ratio was 1.28 (95 % CI: 1.02–1.61, Figure 5), suggesting a modest benefit of standard care over routine stress testing.

Conclusion

Routine stress testing in diabetic patients after coronary intervention may not significantly impact outcomes. Further controlled studies are needed to clarify its clinical benefit.

查看原文本刊更多论文

糖尿病患者冠状动脉介入治疗后的常规压力测试：一项系统回顾和荟萃分析。

背景：压力测试是一种广泛应用于心绞痛患者的无创工具，但其在冠状动脉介入治疗后的糖尿病患者中的作用尚不确定。本综述评估了其对这一人群的影响。目的：我们旨在对评估冠心病介入治疗后糖尿病患者死亡、MACE、缺血和反复血运重建的研究进行系统回顾和荟萃分析。方法：我们检索PubMed、Embase和Cochrane，检索关于血运重建术后报告心肌梗死和心血管死亡、缺血、重复血运重建术的糖尿病患者的随机对照试验和队列研究，并汇总死亡率或心肌梗死的风险比。统计学分析使用RStudio和RevMan，通过I²统计评估异质性。结果：我们纳入了来自15项研究（14个观察性队列，1个随机对照试验）的14,461例患者，所有患者均患有糖尿病和既往血运重建术。随访1 ~ 5.2年，平均年龄60.8±9.5岁，男性占75%。心肌梗死和心血管死亡发生率为11.24% (95% CI: 7.35-15.79%；结论：糖尿病患者冠状动脉介入治疗后常规应激测试对预后无显著影响。需要进一步的对照研究来阐明其临床益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.