Agarwal Rajender, Saini Abhimanyu, Alyousef Tareq, Umscheid Craig A
Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Ann Noninvasive Electrocardiol. 2012 Oct;17(4):291-8. doi: 10.1111/j.1542-474X.2012.00538.x. Epub 2012 Aug 13.
Coronary artery disease (CAD) has a significant disease burden making early diagnosis and management imperative. Magnetocardiography (MCG) is a relatively new noninvasive technique that allows diagnosis of CAD by recording the magnetic fields generated by the electrical activity of the heart.
We searched MEDLINE and the Cochrane Central Register of Controlled Trials for prospective studies that evaluated the test characteristics (e.g., sensitivity, specificity, likelihood ratios) of MCG for detection of CAD. Studies were included if they evaluated either patients with stable CAD documented by angiogram or patients presenting initially with acute coronary syndrome and subsequently diagnosed with CAD. The quality of included studies was assessed using an adaptation of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. We performed meta-analyses of sensitivity, specificity and positive and negative likelihood ratios using Meta-DiSc software.
Screening of titles and abstracts followed by full-text review yielded seven studies that met our inclusion criteria. Meta-analyses yielded a pooled sensitivity of 83% (95% confidence interval [CI] 80% to 86%) and a specificity of 77% (95% CI 73% to 81%). The pooled positive likelihood ratio was 3.92 (95% CI 2.30 to 6.66) and negative likelihood ratio was 0.20 (95% CI 0.12 to 0.35). Significant heterogeneity was present in all meta-analyses.
The pooled test characteristics for MCG are similar to those of existing noninvasive modalities for diagnosing CAD. Our results suggest that MCG is a potential complementary or alternative tool for noninvasive detection of CAD.
冠状动脉疾病(CAD)具有重大的疾病负担,因此早期诊断和管理至关重要。心磁图(MCG)是一种相对较新的非侵入性技术,可通过记录心脏电活动产生的磁场来诊断CAD。
我们检索了MEDLINE和Cochrane对照试验中心注册库,以查找评估MCG检测CAD的测试特征(如敏感性、特异性、似然比)的前瞻性研究。如果研究评估了血管造影记录的稳定CAD患者或最初表现为急性冠状动脉综合征并随后被诊断为CAD的患者,则纳入研究。使用诊断准确性研究质量评估(QUADAS)工具的改编版评估纳入研究的质量。我们使用Meta-DiSc软件对敏感性、特异性以及阳性和阴性似然比进行了荟萃分析。
通过标题和摘要筛选,随后进行全文审查,得出七项符合我们纳入标准的研究。荟萃分析得出合并敏感性为83%(95%置信区间[CI]80%至86%),特异性为77%(95%CI73%至81%)。合并阳性似然比为3.92(95%CI2.30至6.66),阴性似然比为0.20(95%CI0.12至0.35)。所有荟萃分析中均存在显著异质性。
MCG的合并测试特征与现有诊断CAD的非侵入性方法相似。我们的结果表明,MCG是CAD非侵入性检测的一种潜在补充或替代工具。