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Meta-analysis of the effectiveness of heparin in suppressing physiological myocardial FDG uptake in PET/CT

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The present meta-analysis aims to investigate the effectiveness of heparin administration in suppressing physiological myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT), as its role in this regard has not been well investigated.

Methods

PRISMA guidelines were used to interrogate the PubMed, Embase, Cochrane library, Web of Knowledge, and www.clinicaltrail.gov databases from the earliest records to March 2023. The final analysis included five randomized controlled trials (RCTs). Meta-analysis was conducted to compare the effectiveness of unfractionated heparin (UFH) administration versus non-UFH administration, and subgroup analysis based on fixed and variable fasting durations was conducted. Effect sizes were pooled using a random-effects model, and the pooled odds ratios (ORs) were calculated.

Results

Five eligible RCTs with a total of 910 patients (550 with heparin, 360 without heparin) were included. The forest plot analysis initially indicated no significant difference in the suppression of myocardial FDG uptake between the UFH and non-UFH groups (OR 2.279, 95% CI 0.593 to  8.755, p = 0.23), with a high degree of statistical heterogeneity (I2 = 91.16%). Further subgroup analysis showed that the fixed fasting duration group with UFH administration had statistically significant suppression of myocardial FDG uptake (OR 4.452, 95% CI 1.221 to 16.233, p = 0.024), while the varying fasting duration group did not show a significant effect.

Conclusions

According to the findings of our meta-analysis, we suggest that intravenous administration of UFH can be considered as a supplementary approach to suppress myocardial FDG uptake.

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Abbreviations

CI:

Confidence interval

FDG:

18F-fluorodeoxyglucose

FFA:

Free fatty acid

HFLCD:

High-fat, low-carbohydrate diet

LCD:

Low-carbohydrate diet

OR:

Odds ratio

PET/CT:

Positron emission tomography/computed tomography

RCT:

Randomized controlled trial

UFH:

Unfractionated heparin

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Acknowledgements

We thank Dr. I-Chen Tsai for his valuable suggestions on the meta-analysis method.

Disclosures

The authors have no relationships to disclose.

Author information

Author notes

  1. Shan-Ho Chan and Cheng-Kai Huang have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan

    Shan-Ho Chan PhD & Cheng-Kai Huang MSc

  2. Department of Nuclear Medicine, Cheng-Ching General Hospital, Chung-Kang Branch, Taichung, Taiwan

    Cheng-Kai Huang MSc

  3. Institute of Statistical Science, Academia Sinica, Taipei, Taiwan

    Dmytro Luzhbin PhD

  4. Department of Nuclear Medicine, Chang-Bing Show Chwan Memorial Hospital, Changhua, Taiwan

    Po-Nien Hou MD

  5. Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei, 11221, Taiwan

    Yu-Ting Chang Bs & Jay Wu PhD

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  1. Shan-Ho Chan PhD
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  3. Dmytro Luzhbin PhD
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Correspondence to Jay Wu PhD.

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Chan, SH., Huang, CK., Luzhbin, D. et al. Meta-analysis of the effectiveness of heparin in suppressing physiological myocardial FDG uptake in PET/CT. J. Nucl. Cardiol. 30, 2454–2463 (2023). https://doi.org/10.1007/s12350-023-03296-2

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  • DOI: https://doi.org/10.1007/s12350-023-03296-2

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