Angio-IMR demonstrated high diagnostic performance for predicting IMR with a pooled sensitivity of 0.84, specificity of 0.87, and an AUC of 0.91 (95% CI 0.89-0.94).
Meta-Analysis (n=2,202)
Does Angio-IMR accurately diagnose coronary microvascular dysfunction compared to invasive IMR in patients evaluated for CMD?
Angio-IMR demonstrates high diagnostic accuracy for coronary microvascular dysfunction compared to invasive IMR, offering a potential alternative tool.
Effect estimate: AUC 0.91 (95% CI 0.89-0.94)
INTRODUCTION: There is a lack of consensus on diagnosing coronary microvascular dysfunction (CMD) using the angiography-based index of microcirculatory resistance (Angio-IMR) due to the absence of evidence. This study aimed to explore the efficacy of Angio-IMR in diagnosing CMD. METHODS: A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library for studies primarily focusing on Angio-IMR diagnosing CMD, using IMR as the gold standard. The primary results were pooled sensitivity, specificity, and the area under the curve (AUC). RESULTS: A total of 15 studies involving 2,202 individuals and 2,330 vessels were included in our study, Angio-IMR demonstrated high performance in predicting IMR with overall pooled sensitivity and specificity of 0.84 (95% confidence interval (CI): 0.81-0.87) and 0.87 (95% CI: 0.83-0.99), respectively, and AUC = 0.91 (95% CI: 0.89-0.94). This indicates that Angio-IMR has good diagnostic characteristics. Subgroup analysis by indirect meta-analysis showed higher sensitivity in the rest state. However, there is no significant difference in sensitivity and specificity between the hyperemic and rest states when using the AccuIMR system. Furthermore, sensitivity and specificity were more pronounced in the group without coronary pressure monitoring compared to the group with monitoring. CONCLUSION: Angio-IMR is an alternative tool to identify CMD.
Wen et al. (2024) conducted a meta-analysis in Coronary microvascular dysfunction (n=2,202). Angiography-based index of microcirculatory resistance (Angio-IMR) vs. Index of microcirculatory resistance (IMR) was evaluated on Pooled sensitivity, specificity, and area under the curve (AUC) (AUC 0.91, 95% CI 0.89-0.94). Angio-IMR demonstrated high diagnostic performance for predicting IMR with a pooled sensitivity of 0.84, specificity of 0.87, and an AUC of 0.91 (95% CI 0.89-0.94).
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