Impact of Cardiovascular Imaging Results on Medication Use and Adherence: A Systematic Review and Meta-Analysis

Introduction: Cardiovascular imaging results offer valuable information that can guide health decisions, but their impact on medication use and adherence is unclear. This systematic review and meta-analysis aimed to determine the downstream impact of cardiovascular imaging results on medication use and adherence. Methods: Searches were conducted across databases, including MEDLINE, PsychINFO, EMBASE, and relevant references up to 2024. Data were extracted from studies comparing outcomes for individuals with diseased versus normal arteries and trials comparing outcomes for individuals who were provided imaging results versus those with no access to imaging results and analysed in 2023 and 2024. Pooled odds ratios (ORs) for outcomes were calculated. Results: The analysis included 29 studies with 24 contributing data points. Initiation (OR:2.77;95% CI:1.82–4.20) and continuation (OR:2.06;95% CI:1.28–3.30) of lipid-lowering medications (LLMs), antihypertensives (OR:2.02;95% CI:1.76–2.33), and antiplatelets (OR:2.47;95% CI:1.68–3.64) were significantly higher in individuals with diseased arteries. The proportion of individuals on LLM increased by 2.7-fold in those with diseased arteries and 1.5-fold in those with normal arteries post-screening. The proportion on LLM increased by 4.2 times in the imaging group and 2.2 times in the "no imaging group" post-screening. There was a significant increase in LLM initiation (OR:2.37;95% CI: 1.17–4.79) in the imaging group, but medication continuation did not significantly differ between the imaging and "no imaging group". Discussion: Cardiovascular imaging results can prompt initiation of medications, particularly lipid-lowering medications, reflecting a proactive response to identified risk factors. However, evidence regarding medication continuation is mixed, and further research is required.