Diagnostic accuracy and prognostic value of cardiovascular magnetic resonance (CMR) in patients with suspected acute coronary syndrome: a meta-analysis
Authors' conclusion
CMR can detect obstructive CAD and diagnose NSTE-ACS with excellent pooled sensitivity and specificity. CMR findings are strongly associated with clinical outcome in patients with suspected NSTE-ACS.
Study context
- Population
- Patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS)
- Participants
- 1,386 patients16 studies
- Comparison
- Diagnostic accuracy of CMR to detect obstructive coronary artery disease (CAD) and NSTE-ACS, and the prognostic value of CMR in patients with suspected NSTE-ACS
- Outcome
- Detection of obstructive CAD (eight studies)
Methodological detailsbivariate random-effects model, pre-registered in PROSPERO
- Bivariate random-effects model
- Pre-registered in PROSPERO
Pooled result
As reported in the abstract
| Group | Pooled sensitivity | Pooled specificity | Pooled LR+ | Pooled LR- |
|---|---|---|---|---|
| CMR | 85% (95%CI 78-91%) | 73% (95%CI 57-85%) | 3.20 (95%CI 1.78-5.73) | 0.20 (95%CI 0.11-0.36) |
CMR
Pooled sensitivity85% (95%CI 78-91%)
Pooled specificity73% (95%CI 57-85%)
Pooled LR+3.20 (95%CI 1.78-5.73)
Pooled LR-0.20 (95%CI 0.11-0.36)
Further pooled results
| Outcome | CMR |
|---|---|
| Diagnosis of NSTE-ACS (five studies) | |
| Pooled sensitivity | 83% (95%CI 73-89%) |
| Pooled specificity | 89% (95%CI 72-96%) |
| Pooled LR+ | 7.45 (95%CI 2.77-20.02) |
| Pooled LR- | 0.20 (95%CI 0.13-0.30) |
| Prognosis based on ACS-related outcomes (four studies) | |
| Pooled sensitivity | 98% (95%CI 42-100%) |
| Pooled specificity | 85% (95%CI 65-95) |
| Pooled LR+ | 6.55 (95%CI 2.45-17.54) |
| Pooled LR- | 0.03 (95%CI 0-1.54) |
Original publication
Diagnostic accuracy and prognostic value of CMR in patients with suspected acute coronary syndrome: a meta-analysis. Eur Heart J Cardiovasc Imaging. Published 16 December 2025. doi:10.
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