Development and validation of a clinical diagnostic model for myocardial ischaemia in borderline coronary lesions based on optical pumped magnetometer magnetocardiography: a prospective observational cohort study

BMJ Open. 2024 Oct 26;14(10):e086433. doi: 10.1136/bmjopen-2024-086433.

Abstract

Objectives: To develop and validate a clinical diagnostic model based on optical pumped magnetometer magnetocardiography (OPM-MCG) for the detection of myocardial ischaemia in patients with borderline coronary lesions prior to invasive coronary angiography (ICA).

Design: Prospective observational cohort study.

Setting: Single centre of the China National Clinical Research Centre for Cardiovascular Disease (NCCMRC).

Participants: Adults with borderline coronary lesions on ICA (n=141).

Interventions: Underwent OPM-MCG before ICA and fractional flow reserve measurement.

Results: Five parameters were included in the final diagnostic model: MAgmax-TT, δDtsum-PN, δAgsum-C, δArsum-N and δArmin-N. 1000 bootstrap replications showed that the area under the receiver operating characteristic curve and 95% CI of the diagnostic model were 0.864 (0.803-0.925), with a sensitivity of 79.4%, specificity of 80.8%, positive predictive value of 79.4% and negative predictive value of 80.8%. Decision curve analysis showed a net benefit from the predictive model when the threshold probability of an ischaemic patient was >12%, suggesting the potential utility of the model in the real world.

Conclusions: A nomogram based on five OPM-MCG parameters was developed to assess myocardial ischaemia in patients with borderline coronary lesions and has the potential to reduce the need for unnecessary ICA.

Trial registration number: China Clinical Trial Registry (ChiCTR2300072382).

Keywords: Clinical Trial; Diagnostic Imaging; Ischaemic heart disease.

Publication types

  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • China
  • Coronary Angiography*
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / physiopathology
  • Female
  • Fractional Flow Reserve, Myocardial
  • Humans
  • Magnetocardiography* / instrumentation
  • Magnetocardiography* / methods
  • Male
  • Middle Aged
  • Myocardial Ischemia* / diagnosis
  • Myocardial Ischemia* / physiopathology
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity