Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Feb;27(2):220-31.
doi: 10.1007/s11606-011-1833-3. Epub 2011 Sep 1.

Atherosclerosis screening by noninvasive imaging for cardiovascular prevention: a systematic review

Nicolas Rodondi  1 , Reto Auer, Vanessa de Bosset Sulzer, William A Ghali, Jacques Cornuz
Affiliations
Review

Atherosclerosis screening by noninvasive imaging for cardiovascular prevention: a systematic review

Nicolas Rodondi et al. J Gen Intern Med. 2012 Feb.

Abstract

Background: Noninvasive imaging of atherosclerosis is being increasingly used in clinical practice, with some experts recommending to screen all healthy adults for atherosclerosis and some jurisdictions mandating insurance coverage for atherosclerosis screening. Data on the impact of such screening have not been systematically synthesized.

Objectives: We aimed to assess whether atherosclerosis screening improves cardiovascular risk factors (CVRF) and clinical outcomes.

Design: This study is a systematic review.

Data sources: We searched MEDLINE and the Cochrane Clinical Trial Register without language restrictions.

Study eligibility criteria: We included studies examining the impact of atherosclerosis screening with noninvasive imaging (e.g., carotid ultrasound, coronary calcification) on CVRF, cardiovascular events, or mortality in adults without cardiovascular disease.

Results: We identified four randomized controlled trials (RCT, n=709) and eight non-randomized studies comparing participants with evidence of atherosclerosis on screening to those without (n=2,994). In RCTs, atherosclerosis screening did not improve CVRF, but smoking cessation rates increased (18% vs. 6%, p=0.03) in one RCT. Non-randomized studies found improvements in several intermediate outcomes, such as increased motivation to change lifestyle and increased perception of cardiovascular risk. However, such data were conflicting and limited by the lack of a randomized control group. No studies examined the impact of screening on cardiovascular events or mortality. Heterogeneity in screening methods and studied outcomes did not permit pooling of results.

Conclusion: Available evidence about atherosclerosis screening is limited, with mixed results on CVRF control, increased smoking cessation in one RCT, and no data on cardiovascular events. Such screening should be validated by large clinical trials before widespread use.

PubMed Disclaimer

Figures

Figure. 1
Figure. 1
Flowchart of included studies. CVD cardiovascular disease.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Greenland P, Smith SC, Jr, Grundy SM. Improving coronary heart disease risk assessment in asymptomatic people: role of traditional risk factors and noninvasive cardiovascular tests. Circulation. 2001;104:1863–1867. doi: 10.1161/hc4201.097189. - DOI - PubMed
    1. Smith SC, Jr, Greenland P, Grundy SM. AHA Conference Proceedings. Prevention Conference V: Beyond Secondary Prevention: Identifying the High-Risk Patient for Primary Prevention: Executive Summary. American Heart Association. Circulation. 2000;101:111–116. - PubMed
    1. Naghavi M, Falk E, Hecht HS, et al. From vulnerable plaque to vulnerable patient—Part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol. 2006;98:2H–15H. doi: 10.1016/j.amjcard.2006.03.002. - DOI - PubMed
    1. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK., Jr Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999;340:14–22. doi: 10.1056/NEJM199901073400103. - DOI - PubMed
    1. Detrano R, Guerci AD, Carr JJ, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358:1336–1345. doi: 10.1056/NEJMoa072100. - DOI - PubMed

MeSH terms