Diagnostic accuracy of non-invasive cardiac imaging modalities in patients with a history of coronary artery disease: a meta-analysis
Authors' conclusion
In patients with prior CAD, CCTA, CCTA+CTP and CMR demonstrated high diagnostic performance, whereas SPECT had lower sensitivity.
Study context
- Population
- Patients with prior MI or PCI (populations with ≥50% prior coronary artery disease (CAD)); invasive reference standards
- Participants
- 3,265 patients18 studies
- Comparison
- Coronary CT angiography (CCTA) vs CCTA+CTP vs cardiac MRI (CMR) vs single-photon emission CT (SPECT) for detecting obstructive CAD
- Outcome
- Per-patient diagnostic performance for obstructive CAD (sensitivity, specificity, AUC)
Methodological detailsprospective, blinded studies, Searched PubMed, Embase, Web of Science and Cochrane Library, 2005 to September 2022
- Prospective, blinded studies
- Searched PubMed, Embase, Web of Science and Cochrane Library, 2005 to September 2022
Pooled result
As reported in the abstract
Per-patient diagnostic accuracy for obstructive CAD
| Group | AUC | Sensitivity | Specificity |
|---|---|---|---|
| CCTA | 0.91 (95% CI 0.86 to 0.98) | 0.95 (95% CI 0.92 to 0.98) | 0.37 (95% CI 0.29 to 0.46) |
| CCTA+CTP | 0.89 (95% CI 0.73 to 1.00) | 0.93 (95% CI 0.84 to 0.98) | 0.59 (95% CI 0.49 to 0.69) |
| CMR | 0.91 (95% CI 0.80 to 1.00) | 0.91 (95% CI 0.86 to 0.94) | 0.69 (95% CI 0.53 to 0.81) |
| SPECT | 0.70 (95% CI 0.58 to 0.87) | 0.63 (95% CI 0.52 to 0.73) | 0.66 (95% CI 0.56 to 0.76) |
AUC
CCTA0.91 (95% CI 0.86 to 0.98)
CCTA+CTP0.89 (95% CI 0.73 to 1.00)
CMR0.91 (95% CI 0.80 to 1.00)
SPECT0.70 (95% CI 0.58 to 0.87)
Sensitivity
CCTA0.95 (95% CI 0.92 to 0.98)
CCTA+CTP0.93 (95% CI 0.84 to 0.98)
CMR0.91 (95% CI 0.86 to 0.94)
SPECT0.63 (95% CI 0.52 to 0.73)
Specificity
CCTA0.37 (95% CI 0.29 to 0.46)
CCTA+CTP0.59 (95% CI 0.49 to 0.69)
CMR0.69 (95% CI 0.53 to 0.81)
SPECT0.66 (95% CI 0.56 to 0.76)
- Obstructive CAD prevalence
- 64%
Original publication
Diagnostic accuracy of non-invasive cardiac imaging modalities in patients with a history of coronary artery disease: a meta-analysis. Heart. Published 23 August 2024. doi:10.
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