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.
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