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Quantitative myocardial contrast echocardiography during pharmacological stress for diagnosis of coronary artery disease: a systematic review and meta-analysis of diagnostic accuracy studies
European Journal of Echocardiography, 06/25/09

Abdelmoneim SS et al. – Evidence supports use of quantitative myocardial contrast echocardiography (MCE) as a non-invasive test for detection of coronary artery disease (CAD). Standardizing MCE quantification analysis and adherence to reporting standards for diagnostic tests may enhance the quality of evidence in this field.

Methods

Meta-analysis to evaluate the accuracy of quantitative stress MCE in CAD
Database search through January 2008
Inclusion of studies evaluating accuracy of quantitative stress MCE for detection of CAD vs coronary angiography or single-photon emission computed tomography (SPECT) and measuring reserve parameters of A, beta, and Abeta
Data verified and supplemented by study authors
Random effects meta-analysis to estimate weighted mean difference (WMD), likelihood ratios (LRs), diagnostic odds ratios (DORs), and summary area under curve (AUC), all with 95% confidence interval (CI)
Of 1443 studies, 13 studies eligible: 627 pts (age range, 38–75 yrs); comparing MCE vs angiography (10), SPECT (1), or both (2)

Results

WMD significantly less in CAD vs no-CAD group for A, beta, Abeta reserves
Pooled LRs for positive test: 1.33 (1.13–1.57), 3.76 (2.43–5.80), and 3.64 (2.87–4.78) for A, beta, Abeta reserves, respectively
Pooled LRs for negative test: 0.68 (0.55–0.83), 0.30 (0.24–0.38), and 0.27 (0.22–0.34) for A, beta, Abeta reserves, respectively
Pooled DORs: 2.09 (1.42–3.07), 15.11 (7.90–28.91), and 14.73 (9.61–22.57) for A, beta, Abeta reserves, respectively
AUCs were 0.637 (0.594–0.677), 0.851 (0.828–0.872), and 0.859 (0.842–0.750) for A, beta, Abeta reserves, respectively

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