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Original ResearchImpact of Patient Visualization of Cardiovascular Images on Modification of Cardiovascular Risk Factors: Systematic Review and Meta-Analysis
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Study design
This systematic review was undertaken in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement.12 The review was registered with PROSPERO (ID 288686) in November 2021.
Published Reports search
PubMed, Cochrane, and Embase electronic databases using Ovid were searched from inception to November 2021 for randomized controlled trials that assessed the role of cardiovascular (CV) imaging and patient visualization of atherosclerotic plaque on reducing CV risk in
Search results
We identified 4,714 records in the initial search. After removal of duplicates (n = 557), 4,157 were screened for suitability by comparing titles and abstracts with selection criteria. We retrieved the full text for 19 studies and excluded 10, due to study design (n = 8) or incomplete data (n = 2). Nine full-text papers were reviewed for data extraction and 4 authors were contacted to provide patient-level data because of incomplete CV risk information. One author14 provided patient-level data
Discussion
To the best of our knowledge, this study is the first meta-analysis to determine whether patient visualization of CV images improves the estimated 10-year FRS CV risk13 and individual CV risk factors. There was an almost 1% reduction in 10-year FRS observed in those individuals who were provided with pictorial images of their CAC scan or CU and a personalized risk discussion, compared with those who were not provided this information. This meta-analysis was only able to evaluate CV risk
Conclusions
This study has demonstrated that patient visualization of CV images within a CV risk discussion is an effective tool in educating and motivating individuals to engage in risk modification. CV imaging has a beneficial effect on improving both lipid and nonlipid CV risk factors, as well as overall CV risk score. Evidence supporting the use of CV imaging for improving patient understanding and adherence may help to justify the wider use of CAC scanning at a population-based level.
Funding Support and Author Disclosures
Supported in part by a grant from the Ernst Heine Foundation, Sydney, Australia. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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Harvey Hecht, MD, served as Guest Editor for this paper.
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