Evaluating risk factors of embolism in patients with cardiac myxoma: A systematic review and meta-analysis

Abstract

Background

Cardiac myxomas (CM), the most common primary cardiac tumors, can cause embolism in about 40 % of cases, making it crucial to identify risk factors for guiding clinical decisions.

Objectives

In this meta-analysis, we studied the risk factors associated with embolism among patients with cardiac myxomas.

Methods

A comprehensive search was conducted across PubMed, Embase, and Cochrane Library from their inception until May 2023. Statistical analyses were performed using Cochrane's RevMan 5.4 software. For each risk factor, the pooled odds ratio or mean difference was calculated along with the corresponding 95 % confidence interval.

Results

This meta-analysis incorporated 18 studies with 2601 patients, of whom 525 (20.1 %) experienced embolism. Significant risk factors included hypertension (p = 0.001), NYHA I/II (p = 0.03), irregular tumor surface (p < 0.01), hyperlipidemia (p < 0.01), coronary artery disease (p = 0.01), elevated mean platelet volume (p = 0.02), and high tumor mobility (p < 0.01), while female gender (p = 0.03) was linked to reduced risk. Smoking, atrial fibrillation, tumor size, age, BMI, diabetes, LVEF, and LAD were not significantly associated with embolism (p > 0.05).

Conclusion

This analysis is the first to highlight significant pooled outcomes for gender, hyperlipidemia, coronary artery disease, mean platelet volume, and tumor mobility. Patients with these risk factors may benefit from early evaluation and surgery to reduce embolism risk. Statistical analyses were performed using RevMan 5.4, with pooled odds ratios or mean differences calculated alongside 95 % confidence intervals.