
==== Front
Medicine (Baltimore)
Medicine (Baltimore)
MD
Medicine
0025-7974
1536-5964
Lippincott Williams & Wilkins Hagerstown, MD

MD-D-24-02103
00014
10.1097/MD.0000000000039551
3
3800
Research Article
Systematic Review and Meta-Analysis
Meticulous nursing care for coronary CT angiography: A systematic review and meta-analysis of randomized controlled trials
Dai Dan-dan MB Dan-danDai@hotmail.com
a
Jia Chun-yi MB chun-yijia1985@outlook.com
b
Wang Yi-ning MB Yi-ningwang1990@hotmail.com
c
Ma Jing MB Jingma1980@outlook.com
a
https://orcid.org/0009-0006-4229-8847
Bi Xin-yuan MB a*
a Department of Nursing Care, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang, China
b Department of Interventional Radiology, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang, China
c Department of Cardiology, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang, China.
* Correspondence: Xin-yuan Bi, Department of Nursing Care, The Second Affiliated Hospital of Mudanjiang Medical University, No.3, Xiaoyun Street, Mudanjiang, 157000, China (e-mail: Xin-yuanBi@outlook.com).
06 9 2024
06 9 2024
103 36 e3955127 2 2024
12 8 2024
13 8 2024
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

Background:

This study aimed to investigate the effects of meticulous nursing care (MNC) for patients with coronary heart disease undergoing coronary CT angiography (CCTA).

Methods:

We conducted a comprehensive search of the Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, and Wangfang databases from inception to January 1, 2024. Randomized clinical trials (RCTs) evaluating the effects of MNC for CCTA were included. Outcomes assessed included self-rating anxiety scale (SAS), self-rating depression scale (SDS), overall satisfaction of nursing care (OSNC), examination time (ET, min), radiation dose received (RDR, mSv), breathing control time (BCT), and heart rate control time (HRCT).The methodological quality of all included RCTs was evaluated using the Cochrane risk-of-bias tool, while statistical analysis was conducted using RevMan 5.4 software.

Results:

Six eligible trials involving 1064 patients were included. The results of the meta-analysis showed significant differences in SAS (MD = −2.84, 95% CI [−3.31, −2.37], I2 = 0%, P < .001), SDS (MD = −2.55, 95% CI [−3.51, −1.58], I2 = 0%, P < .001), OSNC (OR = 3.13, 95% CI [1.59, 6.17], I2 = 23%, P = .001), BCT (MD = −23.43, 95% CI [−25.07, −21.80], I2 = 45%, P < .001), HRCT (MD = −20.08, 95% CI [−21.70, −18.46], I2 = 29%, P < .001), ET (MD = −2.31, 95% CI [−2.56, −2.06], I2 = 5%, P < .001), and RDR (MD = −2.11, 95% CI [−2.45, −1.77], I2 = 0%, P < .001).

Conclusion:

MNC may benefit for patients with coronary heart disease undergoing CCTA. Future studies are still needed to warrant the current findings.

Coronary CT angiography
meta-analysis
meticulous nursing care
systematic review
Research Project of the Heilongjiang Health Commission20231414050484 Dan-dan DaiOPEN-ACCESSTRUE
==== Body
pmc 1. Introduction

Coronary computed tomography angiography (CCTA) is a recognized diagnostic modality for excluding coronary artery stenosis.[1] It can relatively non-invasively display information such as the course, morphology, distribution, and luminal status of the left and right coronary arteries and their major branches. CCTA can effectively identify the location, extent, and severity of coronary artery obstructive lesions, providing clinical diagnostic evidence supported by a high degree of scientific and clinical evidence.[2] According to the 2019 revised guidelines of the European Society of Cardiology, CCTA has become a first-line diagnostic tool for coronary heart disease.[3] Despite its high standardization, the diagnostic significance of CCTA still heavily relies on optimal imaging performance. Meanwhile, the diagnostic accuracy of CCTA is affected by factors such as ionizing radiation hazards, contraindications to contrast agents, artifacts caused by severe calcification, and metallic artifacts from stents.[4] Particularly, after undergoing CCTA, patients may experience increased psychological stress and pain, decreased exercise capacity, and are prone to severe stress reactions, leading to exacerbated anxiety, depression, and other negative emotions, significantly impairing their quality of life.[5] Therefore, implementing proactive and effective nursing interventions for patients is of great significance in stabilizing their heart rate, improving examination efficiency, and increasing nursing satisfaction rates.

Routine nursing care (RNC) includes conducting health education before the examination, vital signs monitoring (such as measuring blood pressure, heart rate, etc.), explaining the CCTA examination process and precautions to patients, providing guidance on correct breathing techniques.[6] If patients exhibit obvious negative emotions, timely comfort should be provided. However, this traditional nursing approach has limited effects. Therefore, it is essential to implement necessary personalized nursing interventions to bring joy to the physical and mental well-being of patients and improve effects.

Meticulous nursing care (MNC) establishes corresponding nursing standards and systems, making nursing methods and techniques more specific to ensure efficiency and safety.[7–12] In China, nursing practitioners have integrated the concept and theory of meticulous nursing into nursing practice in accordance with the country’s situation, continuously improving it, and achieving rich research results.[7] The development of meticulous nursing is bound to promote the development of hospital detail management, continuously optimize medical processes, strengthen the concept of detail-oriented service by medical staff, and enable patients to enjoy more convenient medical resources and more humane services. Shifting personal views, strengthening detail management, will help hospitals build high-quality and trustworthy service brands, enhance the hospital’s level of diagnosis and treatment, and overall competitiveness.[8] Nursing work has evolved into a discipline that focuses on various aspects such as the psychological, mental, and cultural well-being of patients and their families, based on the application of professional medical theories and skills to provide dynamic information on the occurrence and development of the disease.[9] Meticulous nursing work adheres to such disciplinary concepts, further enriches the connotation of nursing discipline in clinical practice, and promotes the vigorous development of the nursing profession.

Currently, CCTA is extensively employed to assess heart conditions in patients. Numerous previous studies have highlighted the potential benefits of MNC for patients undergoing CCTA.[13–18] However, there lacks a comprehensive and systematic investigation regarding the specific effects of MNC for patients undergoing CCTA. Consequently, the primary objective of this study is to thoroughly analyze and compare the effects of using MNC with RNC in patients undergoing CCTA.

2. Methods

2.1. Ethical approval statement

This study did not need ethical approval, as it harvested secondary data from published studies.

2.2. Eligibility criteria

This study included studies as follows: patients diagnosed with coronary heart disease who underwent CCTA; randomized controlled trial (RCT) design; participants in the treatment group received MNC, while cases in the control group underwent RNC; and there were no restrictions based on gender, race, or region.

This study excluded studies as follows: duplicate studies; unrelated studies, including non-clinical trials, case reports, inappropriate controls, and non-RCTs; and studies lacking sufficient data.

2.3. Search strategy for eligible records

A thorough literature search was performed across electronic databases including Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, and Wangfang databases from initiation up to January 1, 2024. Language restrictions were not imposed. The following search terms were applied: “coronary heart disease,” “coronary artery disease,” “coronary artery disorder,” “coronary disease,” “coronary atherosclerosis,” “ischemic heart disease,” “coronary computed tomography angiography,” “cardiac CT angiography,” “coronary artery CT angiography,” “CT coronary angiography,” “meticulous nursing care,” “refined nursing care,” “precise nursing care,” “routine nursing care,” “regular nursing care,” “standardized nursing care,” “conventional nursing care,” and “traditional nursing care.”

2.4. Outcome measurement

The evaluated outcomes encompassed the self-rating anxiety scale (SAS), self-rating depression scale (SDS), overall satisfaction of nursing care (OSNC), examination time (ET, min), radiation dose received (RDR, mSv), breathing control time (BCT), and heart rate control time (HRCT).

2.5. Study selection, data extraction, and risk of bias assessment

Two authors independently carried out the process of selecting relevant studies, extracting data from these, and evaluating the quality of the methods used in each study. This rigorous approach ensured that the research process was thorough and unbiased. However, if there were any disagreements or inconsistencies in their assessments, a third author was involved in resolving these discrepancies. This third author acted as a mediator, facilitating discussions between the 2 authors or seeking external expert consultation if needed. Ultimately, their goal was to reach a final decision on the inclusion or exclusion of each study, based on a consensus among the authors.

The data extraction process in this study involved the use of a specially designed data extraction sheet. This sheet included various categories of information that were collected from the included studies. Some of the information that was collected included general publication details such as the title, first author, and year of publication. Patient-specific information such as age and sex was also collected. In addition, the study design details were extracted, including information about the sample size, randomization process, blinding, and allocation. Details about the treatment and control groups, such as the dose and frequency of the interventions, were also recorded. Lastly, the outcomes of the studies were extracted, which provided information about the effectiveness of the interventions being investigated. To evaluate the methodological quality of the included studies, the Cochrane risk-of-bias tool was utilized. This tool is a well-established instrument for assessing the risk of bias in randomized controlled trials. It allows researchers to evaluate the potential sources of bias in a systematic and standardized manner. By using this tool, the researchers were able to evaluate the quality of the included studies and assess the reliability of their findings.

2.6. Statistical analysis

In this study, the statistical analysis was performed using RevMan 5.4 software. Continuous values were reported using the mean difference (MD) with a 95% confidence interval (CI). For dichotomous values, odds ratios (OR) were calculated along with their corresponding 95% CI. To assess potential statistical heterogeneity among the included trials, the I² index was used. The I² index is a statistical measure that quantifies the proportion of total variation across studies that is due to heterogeneity rather than chance. A higher value of I² indicates greater heterogeneity among the trials. Finally, the outcome data from the included trials were synthesized using a random-effects model. The random-effects model provides a more conservative estimate of the treatment effect. This approach is appropriate when there is a potential variation in effect sizes across the included trials.

3. Results

3.1. Study characteristics

A total of 252 records were initially searched (Fig. 1). Following the selection process, 246 records were excluded due to duplication or irrelevance, leaving 6 eligible trials involving 1064 patients for analysis (Fig. 1). The general characteristics of these 6 included RCTs are outlined in Table 1. All studies were conducted in China, with sample sizes ranging from 98 to 400. Notably, all patients in the intervention group received MNC, while those in the control group underwent RNC.

Table 1 General characteristics of included studies.

Study	Country	No of patients (T/C)	Age (yr, I/C)	Intervention	Control	Outcomes	
Fan et al 2019	China	55/55	I:54.09 ± 6.61; C:53.28 ± 6.19	MNC	RNC	ET, RDR	
Jin et al 2021	China	118/118	I:66.74 ± 10.85; C:65.28 ± 10.52	MNC	RNC	SAS, SDS, OSNC	
Li 2020	China	50/50	I:69.5 ± 4.9; C:68.4 ± 5.2	MNC	RNC	SAS, BCT, HRCT	
Liu 2022	China	49/49	I:62.35 ± 1.23; C:62.4 ± 1.22	MNC	RNC	SAS, SDS, OSNC	
Zhang 2021	China	200/200	I:53.69 ± 6.24; C:54.52 ± 6.48	MNC	RNC	SAS, SDS, BCT, HRCT, ET, RDR	
Zheng 2021	China	60/60	I:54.69 ± 4.82; C:54.97 ± 4.13	MNC	RNC	ET	
BCT = breathing control time, C = control group, ET = examination time (min), HRCT = heart rate control time, I = intervention group, MNC = meticulous nursing care, OSNC = overall satisfaction of nursing care, RDR = radiation dose received (mSv), RNC = routine nursing care, SAS = self-rating anxiety scale, SDS = self-rating depression scale.

Figure 1. Flowchart of study selection.

3.2. Study quality assessment

The study quality of all eligible RCTs was assessed using the Cochrane risk-of-bias tool, as depicted in Figure 2. In addition to evaluating allocation concealment and blinding of patients, personnel, and outcome assessment, all 6 RCTs included in the analysis provided comprehensive information regarding random sequence generation, incomplete outcome data, and selective reporting[13–18] (Fig. 2).

Figure 2. Risk of bias summary.

3.3. Meta-analysis of SAS

Four trials involving 834 patients investigated SAS. A statistically significant difference was demonstrated in the SAS (MD = −6.00, 95% CI [−11.16, −0.84], I2 = 99%, P < .001; Table 2, Fig. 3).[14–17] Furthermore, even after removing 2 potential risk trials, a statistical significant difference in subgroup analysis of SAS persisted (MD = −2.84, 95% CI [−3.31, −2.37], I2 = 0%, P < .001; Table 2, Fig. 3).[14,16]

Table 2 Qualitative synthesis of included trials.

Outcome or subgroup	Studies	Participants	Statistical method	Effect estimate	
1.1 SAS	4		Mean difference (IV, random, 95% CI)	Subtotals only	
 1.1.1 SAS	4	834	Mean difference (IV, random, 95% CI)	−6.00 [−11.16, −0.84]	
 1.1.2 Subgroup analysis	2	334	Mean difference (IV, random, 95% CI)	−2.84 [−3.31, −2.37]	
1.2 SDS	3		Mean difference (IV, random, 95% CI)	Subtotals only	
 1.12.1 SDS	3	734	Mean difference (IV, random, 95% CI)	−4.93 [−10.32, 0.46]	
 1.2.2 Subgroup analysis	2	334	Mean difference (IV, random, 95% CI)	−2.55 [−3.51, −1.58]	
1.3 OSNC	2	334	Odds ratio (M–H, fixed, 95% CI)	3.13 [1.59, 6.17]	
1.4 BCT	2	500	Mean difference (IV, fixed, 95% CI)	−23.43 [−25.07, −21.80]	
1.5 HRCT	2	500	Mean difference (IV, fixed, 95% CI)	−20.08 [−21.70, −18.46]	
1.6 ET	3	630	Mean difference (IV, fixed, 95% CI)	−2.31 [−2.56, −2.06]	
1.7 RDR	2	510	Mean difference (IV, fixed, 95% CI)	−2.11 [−2.45, −1.77]	
BCT = breathing control time, ET = examination time (min), HRCT = heart rate control time, OSNC = overall satisfaction of nursing care, RDR = radiation dose received (mSv), SAS = self-rating anxiety scale, SDS = self-rating depression scale.

Figure 3. Meta-analysis of SAS. CI = confidence interval, IV = inverse variance, SAS = self-rating anxiety scale, SD = standard deviation.

3.4. Meta-analysis of SDS

Three trials involving 734 patients evaluated the SDS. The results did not demonstrate statistically significant differences in SDS (MD = −4.93, 95% CI [−10.32, 0.46], I2 = 98%, P = .07; Table 2, Fig. 4).[14,16,17] However, after removing 1 potentially risk study, a statistical significant difference in subgroup analysis was observed in SDS (MD = −2.55, 95% CI [−3.51, −1.58], I2 = 0%, P < .001; Table 2, Fig. 4).[14,16]

Figure 4. Meta-analysis of SDS. CI = confidence interval, IV = inverse variance, SD = standard deviation, SDS = self-rating depression scale.

3.5. Meta-analysis of OSNC

Two trials involving 334 subjects investigated OSNC (Table 2, Fig. 5). A statistically significant difference was exerted in OSNC (OR = 3.13, 95% CI [1.59, 6.17], I2 = 23%, P = .001; Table 2, Fig. 5).[14,16]

Figure 5. Meta-analysis of OSNC. CI = confidence interval, OSNC = overall satisfaction of nursing care.

3.6. Meta-analysis of BCT

Two eligible RCTs involving 500 participants assessed BCT, and the results indicated a statistically significant difference in BCT (MD = −23.43, 95% CI [−25.07, −21.80], I2 = 45%, P < .001; Table 2, Fig. 6).[15,17]

Figure 6. Meta-analysis of BCT. BCT = breathing control time, CI = confidence interval, IV = inverse variance, SD = standard deviation.

3.7. Meta-analysis of HRCT

Two studies with 500 subjects investigated HRCT (Table 2, Fig. 7).[15,17] A significant difference was identified between the 2 groups in HRCT (MD = −20.08, 95% CI [−21.70, −18.46], I2 = 29%, P < .001; Table 2, Fig. 7).[15,17]

Figure 7. Meta-analysis of HRCT. CI = confidence interval, HRCT = heart rate control time, IV = inverse variance, SD = standard deviation.

3.8. Meta-analysis of ET

Three studies involving 630 participants evaluated ET, and the results exerted statistically significant difference in ET (MD = −2.31, 95% CI [−2.56, −2.06], I2 = 5%, P < .001; Table 2, Fig. 8).[15,17,18]

Figure 8. Meta-analysis of ET. CI = confidence interval, ET = examination time, IV = inverse variance, SD = standard deviation.

3.9. Meta-analysis of RDR

Two trials with 510 subjects inspected RDR (Table 2, Fig. 9).[13,17] A significant difference was found between the 2 groups in RDR (MD = −2.11, 95% CI [−2.45, −1.77], I2 = 0%, P < .001; Table 2, Fig. 9).[13,17]

Figure 9. Meta-analysis of RDR. CI = confidence interval, IV = inverse variance, RDR = radiation dose received, SD = standard deviation.

4. Discussion

Coronary artery atherosclerosis, a condition characterized by the buildup of plaque in the arteries that supply blood to the heart, is a leading cause of high-risk cardiac diseases. Because this condition often does not present specific early symptoms, healthcare professionals heavily rely on imaging methods for clinical diagnosis.[19] One commonly used non-invasive imaging method is CCTA. This method offers several advantages, including its simplicity of operation, high safety profile, and remarkable sensitivity and diagnostic accuracy. As a result, it has become the primary tool for assessing coronary artery lesions and diagnosing coronary artery diseases.[20] However, in real-world clinical practice, the imaging quality of CCTA can be significantly influenced by both physical and psychological factors experienced by patients. For instance, patient anxiety or nervousness leading up to the examination can cause elevated blood pressure and heart rate, or inadequate breathing patterns, which in turn can result in respiratory motion artifacts. These factors directly compromise the clarity of the imaging and subsequently affect the accuracy of the diagnostic results.[21] To ensure the success and effectiveness of CCTA examinations, it is therefore crucial to implement proactive and effective nursing interventions targeted towards patients. These interventions aim to address patient anxiety and promote relaxation before the examination, as well as provide appropriate breathing training to minimize respiratory motion artifacts. By doing so, healthcare professionals can enhance the overall imaging quality, leading to more accurate diagnostic outcomes and better patient care.

MNC is a tailored management approach that is specifically designed for individual patients. Its main objective is to constantly improve and optimize the overall quality of nursing care provided. By implementing various management principles into nursing interventions, MNC aims to enhance the overall quality of nursing services and ensure that patients receive the highest standard of care possible. Previous research studies have already shown that MNC can be particularly beneficial for patients with coronary heart disease who have undergone CCTA.[13–18] However, despite these findings, there is currently a lack of comprehensive and systematic research that fully investigates the effects of MNC specifically for patients undergoing CCTA. This study aims to fill this gap by conducting a thorough evaluation of the effects of MNC for patients who are undergoing CCTA.

This systematic review and meta-analysis involved 6 studies, with a total of 1064 patients participating. The researchers analyzed the data and found significant differences in several aspects of the patients’ conditions. Firstly, the results showed that there were significant differences in the SAS scores between the 2 groups. The MD was −2.84, with a 95% CI ranging from −3.31 to −2.37. The level of heterogeneity I2 was 0%, indicating a low level of variation among the studies. The P value was <.001, suggesting that these differences were statistically significant. This indicates that patients who received MNC treatment had lower anxiety levels compared to those who received RNC treatment. Similar findings were observed with the SDS scores. The MD was −2.55, with a 95% CI ranging from −3.51 to −1.58. The I2 was 0%, indicating low heterogeneity, and the P value was <.001, indicating statistical significance. This suggests that MNC treatment led to lower levels of depression in patients compared to RNC treatment. The results also showed significant differences in terms of OSNC. The OR was 3.13, with a 95% CI ranging from 1.59 to 6.17. The I2 was 23% and the P value was .001. This suggests that patients who underwent MNC treatment had a higher likelihood of experiencing improved overall satisfaction compared to those who underwent RNC treatment. Furthermore, significant differences were observed in several other measures. For example, the researchers found a significant difference in the BCT scores, with an MD of −23.43, a 95% CI ranging from −25.07 to −21.80, and an I2 of 45%. This indicates that patients who received MNC treatment had lower scores on the BCT, suggesting better outcomes for breathing control compared to those who received RNC treatment. Similar findings were observed for the HRCT scores, with an MD of −20.08, a 95% CI ranging from −21.70 to −18.46, and an I2 of 29%. This suggests that patients who underwent MNC treatment had lower scores on the HRCT, indicating better heart rate control compared to those who underwent RNC treatment. Moreover, the researchers found significant differences in the ET measurements, with an MD of −2.31, a 95% CI ranging from −2.56 to −2.06, and an I2 of 5%. This indicates that patients who received MNC treatment had better ET measurements compared to those who received RNC treatment. Lastly, the researchers observed significant differences in the RDR measurements, with an MD of −2.11, a 95% CI ranging from −2.45 to −1.77, and an I2 of 0%. This suggests that patients who underwent MNC treatment had better outcomes in terms of RDR compared to those who underwent RNC treatment. Overall, these findings suggest that MNC treatment may lead to better outcomes in terms of anxiety, depression, overall satisfaction, breathing control, and heart rate control in patients with coronary heart disease who underwent CCTA compared to those who underwent RNC treatment.

This study had several limitations. Firstly, the included trials exhibited methodological shortcomings that could potentially affect the reliability of the results. The complexity of the nursing care modality itself posed challenges in blinding the participants, therapists, and outcome assessors. Without blinding, there is a risk of bias in the interpretation of outcomes, potentially leading to an overestimation of the intervention effects in this meta-analysis. This lack of blinding also raises concerns about potential reporting biases, as participants and therapists may have had prior knowledge or expectations about the intervention, which could influence their outcomes. Furthermore, the majority of the included studies were conducted in China and were published only in Chinese. This introduces the possibility of cultural and language biases in the meta-analysis results. Different cultures may have varying perceptions and approaches to nursing care, which could influence the effectiveness of the intervention. In addition, this may limit the generalizability of the findings to other populations and settings. In conclusion, while this meta-analysis provides valuable insights into the effectiveness of the nursing care modality, it is important to acknowledge and consider the limitations. Future studies with rigorous methodologies, diverse populations, and publications in multiple languages could further enhance the evidence base in this field.

5. Conclusion

The findings of this study suggest that patients with coronary heart disease who underwent CCTA with MNC may experience benefits compared to those with RNC. However, it is important to note the limitations of this study, and therefore, the current findings should be interpreted with caution. Further research is warranted to validate these findings.

Acknowledgments

This study was partly supported by Research Project of the Heilongjiang Health Commission (No. 20231414050484).

Author contributions

Conceptualization: Dan-dan Dai, Chun-yi Jia, Jing Ma, Xin-yuan Bi.

Data curation: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Xin-yuan Bi.

Formal analysis: Dan-dan Dai, Yi-ning Wang, Xin-yuan Bi.

Funding acquisition: Xin-yuan Bi.

Investigation: Xin-yuan Bi.

Methodology: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma.

Project administration: Xin-yuan Bi.

Resources: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma.

Software: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma.

Supervision: Xin-yuan Bi.

Validation: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma, Xin-yuan Bi.

Visualization: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma, Xin-yuan Bi.

Writing – original draft: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma, Xin-yuan Bi.

Writing – review & editing: Dan-dan Dai, Chun-yi Jia, Yi-ning Wang, Jing Ma, Xin-yuan Bi.

Abbreviations:

BCT breathing control time

CCTA coronary computed tomography angiography

CI confidence interval

ET examination time

HRCT heart rate control time

MD mean difference

MNC meticulous nursing care

OR odds ratio

OSNC overall satisfaction of nursing care

RCTs randomized controlled trials

RDR radiation dose received

RNC routine nursing care

SAS self-rating anxiety scale

SDS self-rating depression scale

The authors have no conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

How to cite this article: Dai D-d, Jia C-y, Wang Y-n, Ma J, Bi X-y. Meticulous nursing care for coronary CT angiography: A systematic review and meta-analysis of randomized controlled trials. Medicine 2024;103:36(e39551).
==== Refs
References

[1] Budoff MJ Achenbach S Blumenthal RS . American Heart Association Committee on Cardiovascular Imaging and Intervention. Assessment of coronary artery disease by cardiac computed tomography. Circulation. 2006;114 :1761–91.17015792
[2] Doris M Newby DE . Coronary CT angiography as a diagnostic and prognostic tool: perspectives from the SCOT-HEART trial. Curr Cardiol Rep. 2016;18 :18.26782999
[3] Saraste A Knuuti J . ESC 2019 guidelines for the diagnosis and management of chronic coronary syndromes: recommendations for cardiovascular imaging. Herz. 2020;45 :409–20.32430520
[4] Qi L Tang LJ Zhu XM . The diagnostic performance of coronary CT angiography for the assessment of coronary stenosis in calcified plaque. PLoS One. 2016;11 :e0154852.27149622
[5] Zhang Y Zhang G Ge LM . Efficacy observation of dual nursing intervention on patients after coronary artery stent implantation. Chin J Evid Based Cardiovasc Med. 2019;11 :862–3.
[6] Shen HY Shan J Ma DR . Analysis of nursing intervention in coronary artery CT angiography examination. Chin Contin Med Educ. 2019;11 :160–2.
[7] Cui YL . Application of meticulous continuity nursing in elderly patients after PC1 surgery. Chin Rural Heal. 2020;12 :33, 35.
[8] Xu Y . The important role of meticulous nursing care in the operating room nursing work. Chin Med Sci. 2014;4 :105–7.
[9] Chen YY . Research progress on the practice of meticulous nursing care in China. Gen Nurs. 2019;17 :1181–4.
[10] Xiao Q Wang CQ . Application analysis of meticulous nursing care in optimizing coronary artery CT angiography examination schemes. Health Essent Read. 2020;14 :143.
[11] Zhang YL . Research on the application of meticulous nursing care in coronary artery CT angiography examination. Health Friends. 2022;11 :57–8.
[12] Huang C Jiang JP Zhao HX . Application of meticulous nursing care in coronary artery CT imaging examination. Zhejiang Med. 2014;17 :1495–7.
[13] Fan YF Liu YH Cao HH . Application of refined nursing intervention in optimizing coronary artery CT angiography examination schemes. Chin Digit Med. 2019;14 :71–2.
[14] Jin L Zhuang JY Dong YY . Application effect of refined nursing in patients with coronary atherosclerosis undergoing coronary artery CT angiography examination. J Integr Nurs. 2021;7 :9–12.
[15] Li JH . Application of refined nursing intervention in coronary artery CT angiography examination. Clin Med Eng. 2020;27 :1259–60.
[16] Liu SP . Application effect of refined nursing in patients undergoing coronary artery CT angiography examination. Chin J Natl Health. 2022;34 :157–60.
[17] Zhang J . Analysis of the application effect of refined nursing intervention in coronary artery CT angiography examination. Heilongjiang Chin Med. 2021;50 :438–9.
[18] Zheng LM . Value evaluation of refined nursing in the application of coronary artery CT angiography examination. Health Women. 2021;10 :219.
[19] Li SM . The intervention effect of routine care and psychological care on improving the success rate of coronary CT angiography (CTA) examination. Imaging Res Med Appl. 2020;4 :245–6.
[20] He ZW Rong JT Ma XM . The application value of comprehensive nursing intervention in elderly coronary CTA examination. J Med Imaging. 2020;30 :1918–20.
[21] Liu Y . The application value of nursing intervention in coronary CTA examination. Imaging Res Med Appl. 2019;3 :254–5.
