Magnetocardiography for the diagnosis of coronary artery disease: a systematic review and meta-analysis

BackgroundGlobally, coronary heart disease (CHD) is a major public health issue because it significantly increases mortality and medical expenses. In the recent years, magnetocardiography (MCG) has shown its potential as a new tool for diagnosing CHD. However, the quantitative assessment of MCG currently used for CHD diagnosis are insufficient, preventing its full integration into routine clinical practice. MethodsWe searched PubMed (including MEDLINE), Embase, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Data, and ClinicalTrials.gov for studies published up to March 4, 2023. We systematically searched for studies that compare MCG (as the index test) with coronary angiography (as the standard reference) for diagnosing CHD in suspected population. Three authors assessed the quality of the included studies independently using the QUADAS-2 tool. We calculated the pooled value of the sensitivity and specificity of MCG using the bivariate model. To investigate clinical and methodological factors that might contribute to the statistical heterogeneity, we used meta-regression and subgroup analysis. This systematic review and meta-analysis has been conformed to PRISMA guidelines and registered with PROSPERO (number CRD42022332272). ResultsBy searching, we found 174 studies, 18 of them included 2,571 subjects from 6 countries and regions and met the inclusion criteria. The combined values for sensitivity and specificity are 86% (95% CI: 80-91) and 79% (95% CI: 71-86), respectively. The summary receiver operating characteristic (SROC) curves area under the curve was 0.90. We found significant statistical heterogeneity between studies (for sensitivity, I2=94.22% (95% CI: 92.48-95.96), Q=294.11, P<0.01; for specificity, I2=88.98% (95% CI: 84.95-93.01), Q=154.26, P<0.01. ConclusionGiven its high sensitivity, MCG has a high value for diagnosing CHD, especially in primary screening. Further investigation is required to examine additional factors that may affect the performance of MCG considering the limited clinical trials and sample size.