Abstract 13615: Diagnostic Accuracy of Cardiac MRI for Detecting Wall Motion Abnormalities and Coronary Artery Stenosis - A Systematic Review and Umbrella Meta-Analysis

Abstract

Introduction: Conventional coronary angiography (CCA) is the gold standard for the diagnosis of coronary artery disease (CAD). It is an invasive test and carries risks. Increased mortality is linked with reduced coronary flow, thus aggressively measuring coronary flow is important. Cardiac MRI (cMRI) is an emerging non-invasive test that can also help in assessing ventricular function, myocardial perfusion, and detecting anomalies. Aim: We aimed to analyze the diagnostic accuracy of cMRI compared to CCA through an umbrella meta-analysis. Methods: We searched PubMed articles comparing the diagnostic accuracy of cMRI with CCA in patients having CAD published from 2000 to 2022 according to PRISMA guidelines. We used the generic inverse variance method to pool sensitivity (SN), specificity (SP), negative likelihood ratio, positive likelihood ratio, and diagnostic odds ratio (DOR) with 95% confidence interval keeping alpha criteria of 0.05 as significant. RevMan 5.4 was used to calculate random effects models. Results: In this umbrella meta-analysis, 9 studies with 14615 patients met inclusion criteria. Overall pooled SN was 0.88 (95% CI: 0.87-0.90), SP was 0.85 (0.81-0.89), PLR was 6.07 (5.02-7.33), NLR was -1.99 (-2.10 to -1.87), and DOR 38.94 (31.96-47.46). (p<0.00001) Conclusion: The diagnostic accuracy of a non-invasive, cMRI is comparable, if not superior to an invasive test like CCA.