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Dagens #fsvoversigt:
Screening Strategies and Primary Prevention Interventions in Relatives of
People With Coronary Artery Disease: A Systematic Review and Meta-analysis.
Can J Cardiol. 2015 May;31(5):649-57
Authors: Goldfarb M, Slobod D, Dufresne L, Brophy JM, Sniderman A, Thanassoulis
G
Abstract
BACKGROUND: Relatives of people with coronary artery disease are at high risk
of cardiovascular (CV) disease, but the effect of focused screening and
treatment of this population is uncertain.
METHODS: We searched the Cochrane Library, Medline, and Embase from inception
until June 30, 2014 for articles that described screening strategies and
primary prevention interventions targeting family members of patients with
coronary artery disease to reduce CV risk. Results were pooled using a
random-effects meta-analysis.
RESULTS: We identified 18 studies that reported screening strategies and 15
reporting interventions to reduce CV risk. Proband willingness to refer
relatives for screening was high (n = 6 studies, pooled rate = 87%; 95%
confidence interval [CI], 80%-95%). Studies using a screening strategy in which
the relative was contacted by health care professionals reported a pooled
participation rate of 88% (95% CI, 78%-99%). The quality of interventional
studies was highly variable. Random-effects meta-analysis of the highest
quality randomized studies (n = 6) consisting of a specialized risk factor
intervention compared with usual care was consistent with modest improvements
in low-density lipoprotein cholesterol control (-0.18 mmol/L low-density
lipoprotein cholesterol, 95% CI, -0.35 to -0.001; P = 0.048). Improvements in
diet, smoking rates, exercise, and blood pressure were also observed with
active intervention; however, reported outcomes were heterogeneous precluding a
formal met
a-analysis.
CONCLUSIONS: Screening strategies that target family members, particularly when
led by a health care professional, achieve a high participation rate. Although
the available evidence is of variable quality, interventions that target
individuals with a family history of coronary artery disease appear to be
feasible and might be effective in improving certain risk factors or health
behaviours but their long-term CV benefits remain uncertain.
PMID: 25936490 [PubMed - indexed for MEDLINE]
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1O5RZk9
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