Diagnostic Accuracy of Three-Dimensional Whole-Heart Magnetic Resonance Angiography to Detect Coronary Artery Disease with Invasive Coronary Angiography as a Reference: A Meta-Analysis
Objective: We aimed to evaluate the diagnostic performance of three-dimensional whole-heart magnetic resonance coronary angiography (MRCA) in detecting coronary artery disease (CAD) with invasive coronary angiography as the reference standard. Methods: We searched PubMed and Embase for studies evaluating the diagnostic performance of three-dimensional whole-heart MRCA for the diagnosis of CAD with invasive coronary angiography as the reference standard. The bivariate mixed-effects regression model was applied to synthesize available data. The clinical utility of whole-heart MRCA was calculated by the posttest probability based on Bayes’s theorem. Results: Eighteen studies were included, of which 16 provided data at the artery level. Patient-based analysis revealed a pooled sensitivity of 0.90 (95% confidence interval [CI] 0.87–0.93) and specificity of 0.79 (95% CI 0.73–0.84), while the pooled estimates were 0.86 (95% CI 0.82–0.89) and 0.89 (95% CI 0.84–0.92), respectively, at the artery level. The areas under the summary receiver operating characteristic curve were 0.93 (95% CI 0.90–0.95) and 0.92 (95% CI 0.90–0.94) at the patient and artery levels, respectively. With a pretest probability of 50%, the patients’ post-test probabilities of CAD were 81% for positive results and 11% for negative results. Conclusions: Whole-heart MRCA can be an alternative noninvasive method for diagnosis and assessment of CAD.
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Affiliations: Fuwai Hospital, National Center for Cardiovascular Diseases of China, Beijimg, China
Appeared or available online: November 8, 2019