The following is a summary of “Accelerated magnetocardiography in the evaluation of patients with suspected cardiac ischemia: The MAGNETO trial,” published in the April 2024 issue of Cardiology by Mace, et al.
Treating ischemia in emergency department (ED) patients with suspected acute coronary syndrome (sACS) is challenging, with uncertain best approach.
Researchers conducted a prospective study to compare the sensitivity and specificity of magnetocardiography (MCG) versus standard of care (SOC) stress testing in diagnosing myocardial ischemia.
They used a multicenter, observational study in which ED patients with sACS and HEART score≥3 underwent a 90s non-invasive MCG to detect myocardial ischemia. MCGs were read independently by 3 physicians. Myocardial ischemia was ≥70% epicardial coronary artery stenosis, revascularization within 30 days, or 30-day major adverse cardiac events (MACE). Time to first test (TTT) and patient satisfaction for MCG and SOC were compared.
The results studied 390 patients with a mean age of 59±12 years, with 45% female, where 99 (25%) underwent non-invasive stress tests, and 42 (14%) were diagnosed with ischemia. The study found that MCG had a sensitivity of 66.7% (50.5-80.4%, 95% CI) and a specificity of 57.1% (50.0-63.3%, 95% CI) for detecting coronary ischemia. These results were similar to non-invasive stress testing, which had a sensitivity of 66.7% (95% CI 29.9%-92.5%) and a specificity of 89.9% (95% CI 81.7-95.3%). The mean TTT was significantly shorter for MCG – 3.18 hours (SD 1.91) compared to 22.71 hours for SOC stress testing (SD 15.23). P<0.0001. Patients reported a better experience with MCG (4.7) compared to SOC stress testing (3.0) (P<0.0001).
Investigators concluded that MCG provides similar sensitivity and lower specificity to non-invasive stress testing in ED patients with sACS. MCG’s TTT is shorter, and patient satisfaction scores are higher.
Source: sciencedirect.com/science/article/pii/S2666602224000156