Diagnostic value of long noncoding RNAs MIAT and MALAT1 in coronary artery disease: a systematic review and diagnostic accuracy test meta-analysis

Long noncoding RNAs (lncRNAs) MALAT1 and MIAT modulate atherosclerotic progression and myocardial ischemia injury, through vascular endothelial dysfunction. Diagnostic values of these lncRNAs in detecting coronary artery disease (CAD) have been investigated, but the results have been inconsistent. We aimed to evaluate the diagnostic accuracy of lncRNAs MALAT1 and MIAT. A comprehensive search was done to identify case-control studies reporting diagnostic measures of MIAT and MALAT1 in patients with CAD compared to healthy controls. Methodological quality of included studies was assessed using the QUADAS-2 checklist. All analyses were conducted in R software. Hierarchical models were applied to pooled diagnostic performance metrics. We used the “meta” package to estimate the odds ratio (OR) for MALAT1, and to pool sensitivity and specificity for both lncRNAs. We also used the “mada” package to estimate the positive likelihood ratio (PLR), negative likelihood ratio (NLR), area under the receiver operating characteristic curve (AUC), and diagnostic odds ratio (DOR). Meta-regression analyses based on mean age and male percentage were conducted to explore potential sources of heterogeneity. Ten studies were included, encompassing a total of 1,879 individuals (1009 CAD cases and 870 healthy controls) with a mean age of 59.24 years. The diagnostic performance of lncRNA MALAT1 showed a pooled sensitivity of 0.68 and specificity of 0.70, with an AUC of 0.746 and a DOR of 5.17 (95% CI: 2.26–11.85), showing acceptable diagnostic power. For lncRNA MIAT, the pooled sensitivity and specificity were 0.81 and 0.65, respectively, with an AUC of 0.757 and a DOR of 7.64 (95% CI: 2.12–27.47), indicating moderate accuracy. The prognostic value of MALAT1 in CAD was assessed, showing a significant association with disease outcomes (OR = 2.81, 95% CI: 1.04–7.56). This study indicates that both MALAT1 and MIAT demonstrate moderate diagnostic accuracy for CAD, with limitations in their clinical utility. MALAT1 also appears to have prognostic potential, suggesting its broader clinical relevance. Further research in standardized clinical settings is needed to validate these findings and clarify their practical applications in CAD diagnosis and management.