Impact of design characteristics among studies comparing coronary computed tomography angiography to noninvasive functional testing in chronic coronary syndromes
Authors' conclusion
Among studies of any design, CCTA was associated with lower risk of MI in CCS compared to noninvasive functional testing. This benefit was diminished among studies with clinical outcome definition, central outcome assessment/adjudication or at low-risk of bias.
Study context
- Population
- Patients with chronic coronary syndromes15 studies (8 non-randomised, 7 randomised)
- Comparison
- Coronary computed tomography angiography (CCTA) vs noninvasive functional testing
- Outcome
- Myocardial infarction (MI)
Methodological detailsrandom-effects meta-analysis, Hartung-Knapp-Sidik-Jonkman adjustment
- Random-effects meta-analysis
- Hartung-Knapp-Sidik-Jonkman adjustment
Pooled result
As reported in the abstract
CCTA vs Functional testingOdds ratio (95% CI)P value
MI
0.54(0.47–0.62)
P < 0.001CCTA vs Functional testingRD (95% CI)P value
Absolute MI risk
−0.4%(−0.6 to −0.1)
P = 0.005Further pooled results
| Outcome | RD (95% CI) | P value | |
|---|---|---|---|
| MI, by study design (subgroup)CCTAvs Functional testingNon-randomised studies | −0.4% (−0.7 to −0.1) | P = 0.029 | |
| −1−0.500.5Difference (linear scale) |
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| MI, by study characteristics (subgroup)CCTAvs Functional testingClinical outcome definition | 0.77 (0.41–1.44) | P = 0.212 | |
| MI, by study characteristics (subgroup)CCTAvs Functional testingResearch driven follow-up | 0.54 (0.24–1.21) | P = 0.090 | |
| MI, by study characteristics (subgroup)CCTAvs Functional testingCentral event assessment | 0.63 (0.21–1.86) | P = 0.207 | |
| MI, by study characteristics (subgroup)CCTAvs Functional testingOutcome adjudication | 0.74 (0.24–2.23) | P = 0.178 | |
| MI, by study characteristics (subgroup)CCTAvs Functional testingLow risk of bias | 0.74 (0.24–2.23) | P = 0.178 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | RD (95% CI) | P value |
|---|---|---|
| MI, by study design (subgroup)Between CCTA and Functional testing · randomised trials | 0.2% (−0.6 to 0.1) | P = 0.158 |
Original publication
Impact of design characteristics among studies comparing coronary computed tomography angiography to noninvasive functional testing in chronic coronary syndromes. Am Heart J. Published 15 November 2022. doi:10.
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