{"title":"脉搏波速度筛查冠状动脉疾病的准确性:系统回顾和荟萃分析。","authors":"Carla-Geovanna Lever-Megina, Iván Cavero-Redondo, Celia Álvarez-Bueno, Cristina Morales-Berenkova, Germán Cabeza-Arrebola, Alicia Saz-Lara","doi":"10.1515/dx-2024-0193","DOIUrl":null,"url":null,"abstract":"<p><p>Coronary artery disease (CAD) is the leading cause of cardiovascular events and showed high prevalence and healthcare costs in 2019. However, CAD screening for cardiovascular event prevention is invasive and expensive. This study aims to estimate the ability of a noninvasive method, pulse wave velocity (PWV), to detect the presence or absence of coronary artery disease in patients with suspected CAD. A systematic review and meta-analysis of the available evidence was conducted, comparing PWV with the gold standard diagnostic method, angiography. The literature search was systematically performed in the PubMed, Scopus and Web of Science databases from inception to August 2024. Study quality assessment was performed using the Diagnostic Accuracy Study Quality Assessment Tool (QUADAS-2). Publication bias was assessed using the method proposed by Deeks. Statistical analyses were performed with the STATA SE software, version 15. The eight included studies had a cross-sectional design, in which the presence of CAD was measured simultaneously by PWV and angiography. To assess the accuracy of the tests, the overall sensitivity and specificity were combined into a single value, the diagnostic odds ratio (dOR), which provided a value of 3.61, indicating a high probability of detecting CAD by PWV. The implementation of PWV as a screening technique in healthcare centers could bring great benefits to patients with suspected CAD and increase efficiency in the use of healthcare resources.</p>","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Accuracy of pulse wave velocity for screening coronary artery disease: a systematic review and meta-analysis.\",\"authors\":\"Carla-Geovanna Lever-Megina, Iván Cavero-Redondo, Celia Álvarez-Bueno, Cristina Morales-Berenkova, Germán Cabeza-Arrebola, Alicia Saz-Lara\",\"doi\":\"10.1515/dx-2024-0193\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Coronary artery disease (CAD) is the leading cause of cardiovascular events and showed high prevalence and healthcare costs in 2019. However, CAD screening for cardiovascular event prevention is invasive and expensive. This study aims to estimate the ability of a noninvasive method, pulse wave velocity (PWV), to detect the presence or absence of coronary artery disease in patients with suspected CAD. A systematic review and meta-analysis of the available evidence was conducted, comparing PWV with the gold standard diagnostic method, angiography. The literature search was systematically performed in the PubMed, Scopus and Web of Science databases from inception to August 2024. Study quality assessment was performed using the Diagnostic Accuracy Study Quality Assessment Tool (QUADAS-2). Publication bias was assessed using the method proposed by Deeks. Statistical analyses were performed with the STATA SE software, version 15. The eight included studies had a cross-sectional design, in which the presence of CAD was measured simultaneously by PWV and angiography. To assess the accuracy of the tests, the overall sensitivity and specificity were combined into a single value, the diagnostic odds ratio (dOR), which provided a value of 3.61, indicating a high probability of detecting CAD by PWV. The implementation of PWV as a screening technique in healthcare centers could bring great benefits to patients with suspected CAD and increase efficiency in the use of healthcare resources.</p>\",\"PeriodicalId\":11273,\"journal\":{\"name\":\"Diagnosis\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-01-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnosis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1515/dx-2024-0193\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnosis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1515/dx-2024-0193","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
冠状动脉疾病(CAD)是心血管事件的主要原因,在2019年显示出高患病率和高医疗成本。然而,用于预防心血管事件的CAD筛查是侵入性的且昂贵的。本研究旨在评估一种无创方法,即脉冲波速度(PWV),在疑似CAD患者中检测冠状动脉疾病存在与否的能力。对现有证据进行了系统回顾和荟萃分析,将PWV与金标准诊断方法血管造影进行了比较。文献检索系统地在PubMed、Scopus和Web of Science数据库中进行,检索时间从成立到2024年8月。使用诊断准确性研究质量评估工具(QUADAS-2)进行研究质量评估。采用Deeks提出的方法评估发表偏倚。统计学分析采用STATA SE软件,版本15。纳入的8项研究采用横断面设计,其中通过PWV和血管造影同时测量CAD的存在。为了评估测试的准确性,将总体敏感性和特异性合并为一个单一值,即诊断优势比(dOR),该值为3.61,表明PWV检测CAD的概率很高。在医疗中心实施PWV作为筛查技术,可以为疑似CAD患者带来极大的好处,提高医疗资源的使用效率。
Accuracy of pulse wave velocity for screening coronary artery disease: a systematic review and meta-analysis.
Coronary artery disease (CAD) is the leading cause of cardiovascular events and showed high prevalence and healthcare costs in 2019. However, CAD screening for cardiovascular event prevention is invasive and expensive. This study aims to estimate the ability of a noninvasive method, pulse wave velocity (PWV), to detect the presence or absence of coronary artery disease in patients with suspected CAD. A systematic review and meta-analysis of the available evidence was conducted, comparing PWV with the gold standard diagnostic method, angiography. The literature search was systematically performed in the PubMed, Scopus and Web of Science databases from inception to August 2024. Study quality assessment was performed using the Diagnostic Accuracy Study Quality Assessment Tool (QUADAS-2). Publication bias was assessed using the method proposed by Deeks. Statistical analyses were performed with the STATA SE software, version 15. The eight included studies had a cross-sectional design, in which the presence of CAD was measured simultaneously by PWV and angiography. To assess the accuracy of the tests, the overall sensitivity and specificity were combined into a single value, the diagnostic odds ratio (dOR), which provided a value of 3.61, indicating a high probability of detecting CAD by PWV. The implementation of PWV as a screening technique in healthcare centers could bring great benefits to patients with suspected CAD and increase efficiency in the use of healthcare resources.
期刊介绍:
Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality. Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error