From: Evidence review for CT and MRI indications for intervention
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Risk factor and outcome (population) | Number of studies | Effect (95% CI) | Risk of bias | Imprecision | Indirectness | GRADE Quality |
---|---|---|---|---|---|---|
Cardiac death following TR surgery | ||||||
RVEF per 5% higher (continuous variable) on cardiac MRI for predicting cardiac death following TR surgery – follow-up median 57 months (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Adjusted HR 0.71 (0.53 to 0.97) a | Very seriousb | None | Seriousc | VERY LOW |
RVEF <46% vs ≥46% on cardiac MRI for predicting cardiac death following TR surgery – follow-up median 57 months (unadjusted HR estimated from data provided) (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Unadjusted HR 5.06 (1.56 to 16.46) d | Very seriousb | None | Seriousc | VERY LOW |
RV-ESVI per 10 ml/m2 increase (continuous variable) on cardiac MRI for predicting cardiac death following TR surgery – follow-up median 57 months (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Adjusted HR 1.18 (1.03 to 1.37) a | Very seriousb | None | Seriousc | VERY LOW |
RV-ESVI ≥76 ml/m2 vs. <76 ml/m2 on cardiac MRI for predicting cardiac death following TR surgery – follow-up median 57 months (unadjusted HR estimated from data provided) (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Unadjusted HR 0.29 (0.09 to 0.91) d | Very seriousb | None | Seriousc | VERY LOW |
Postoperative cardiac events (cardiac death or unplanned cardiac-related readmission) | ||||||
RVEF per 5% higher (continuous variable) on cardiac MRI for predicting postoperative cardiac events (cardiac death or unplanned cardiac-related readmission) following TR surgery – follow-up median 57 months (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Adjusted HR 0.8 (0.65 to 0.97)a | Very seriousb | None | Seriousc | VERY LOW |
RVEF <46% vs ≥46% on cardiac MRI for predicting postoperative cardiac events (cardiac death or unplanned cardiac-related readmission) following TR surgery – follow-up median 57 months (unadjusted HR estimated from data provided) (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Unadjusted HR 3.94 (1.59 to 9.76)d | Very seriousb | None | Seriousc | VERY LOW |
RV-ESVI per 10 ml/m2 increase (continuous variable) on cardiac MRI for predicting postoperative cardiac events (cardiac death or unplanned cardiac-related readmission) following TR surgery – follow-up median 57 months (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Adjusted HR 1.1 (1 to 1.22)a | Very seriousb | Seriouse | Seriousc | VERY LOW |
RV-ESVI ≥76 ml/m2 vs. <76 ml/m2 on cardiac MRI for predicting postoperative cardiac events (cardiac death or unplanned cardiac-related readmission) following TR surgery – follow-up median 57 months (unadjusted HR estimated from data provided) (severe isolated functional TR undergoing TR surgery, 54.7% in NYHA class III/IV; mean age 59.3 years) | 1 (n=75) | Unadjusted HR 0.46 (0.19 to 1.11)d | Very seriousb | Seriouse | Seriousc | VERY LOW |
Methods: multivariable analysis, adjusted for age, sex, NYHA class, haemoglobin level and glomerular filtration rate
Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias
Population - all underwent intervention for severe functional TR so does not represent population where there is uncertainty about whether there is an indication for intervention; and outcome - only includes cardiac deaths and not all deaths.
Methods: no multivariable analysis, HR estimated from data provided in paper
95% CI crossed null line
From: Evidence review for CT and MRI indications for intervention
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.