You Zhai, Hongcai Shang, Yan Li, Nan Zhang, Jisi Zhang, Shangwen Wu
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Data extraction and synthesis: The literature review, data extraction, and quality evaluation were conducted by two independent researchers, and the meta-analysis was performed using RevMan 5.4 software.</p><p><strong>Main outcomes: </strong>The main outcome was that MACE occurred during the follow-up period.</p><p><strong>Results: </strong>A total of 40 articles were included. The meta-analysis erevealed that dyslipidemia (OR = 1.50; 95% CI [1.19, 1.89], <i>p</i> = 0.0007), diabetes mellitus (OR = 1.70; 95% CI [1.43, 2.02], <i>p</i> < 0.00001), hypertension (OR = 1.62; 95% CI [1.35, 1.96], <i>p</i> < 0.0001), history of smoking (OR = 2.08; 95% CI [1.51, 2.85], <i>p</i> < 0.0001), poorer ventricular function (OR = 2.39; 95% CI [2.17-2.64], <i>p</i> < 0.0001), impaired left ventricular ejection fraction (LVEF) (OR = 1.86; 95% CI [1.71-2.03], <i>p</i> < 0.0001), door to balloon (D-to-B) time (OR = 0.61; 95% CI [0.42-0.88]; <i>p</i> = 0.009), thrombolysis in myocardial infarction (TIMI) (OR = 1.41; 95% CI [1.17, 1.70], <i>p</i> = 0.0004), renal dysfunction (OR = 1.82; 95% CI [1.37, 2.43], <i>p</i> < 0.0001), and multi-vessel coronary artery disease (OR = 0.41; 95% CI [0.37, 0.46], <i>p</i> < 0.0001) were significantly associated with MACE after PCI.</p><p><strong>Conclusion: </strong>The independent risk factors of MACE after PCI are dyslipidemia, hypertension, diabetes mellitus, smoking history, Killip class > II, LVEF ≤40%, D-to-B time >90 min, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease.</p>","PeriodicalId":12477,"journal":{"name":"Frontiers in Physiology","volume":"16 ","pages":"1514585"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014560/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Systematic Review of risk factors for major adverse cardiovascular events in patients with coronary heart disease who underwent percutaneous coronary intervention.\",\"authors\":\"You Zhai, Hongcai Shang, Yan Li, Nan Zhang, Jisi Zhang, Shangwen Wu\",\"doi\":\"10.3389/fphys.2025.1514585\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to systematically review the risk factors for major adverse cardiovascular events (MACE) in patients with coronary heart disease who have undergone percutaneous coronary intervention (PCI).</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources: </strong>The Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese Technical Periodicals (VIP) were screened until December 2024.</p><p><strong>Eligibility criteria for selecting studies: </strong>Case-control studies or cohort studies on the risk factors for MACE in patients with coronary heart disease who underwent PCI. Data extraction and synthesis: The literature review, data extraction, and quality evaluation were conducted by two independent researchers, and the meta-analysis was performed using RevMan 5.4 software.</p><p><strong>Main outcomes: </strong>The main outcome was that MACE occurred during the follow-up period.</p><p><strong>Results: </strong>A total of 40 articles were included. The meta-analysis erevealed that dyslipidemia (OR = 1.50; 95% CI [1.19, 1.89], <i>p</i> = 0.0007), diabetes mellitus (OR = 1.70; 95% CI [1.43, 2.02], <i>p</i> < 0.00001), hypertension (OR = 1.62; 95% CI [1.35, 1.96], <i>p</i> < 0.0001), history of smoking (OR = 2.08; 95% CI [1.51, 2.85], <i>p</i> < 0.0001), poorer ventricular function (OR = 2.39; 95% CI [2.17-2.64], <i>p</i> < 0.0001), impaired left ventricular ejection fraction (LVEF) (OR = 1.86; 95% CI [1.71-2.03], <i>p</i> < 0.0001), door to balloon (D-to-B) time (OR = 0.61; 95% CI [0.42-0.88]; <i>p</i> = 0.009), thrombolysis in myocardial infarction (TIMI) (OR = 1.41; 95% CI [1.17, 1.70], <i>p</i> = 0.0004), renal dysfunction (OR = 1.82; 95% CI [1.37, 2.43], <i>p</i> < 0.0001), and multi-vessel coronary artery disease (OR = 0.41; 95% CI [0.37, 0.46], <i>p</i> < 0.0001) were significantly associated with MACE after PCI.</p><p><strong>Conclusion: </strong>The independent risk factors of MACE after PCI are dyslipidemia, hypertension, diabetes mellitus, smoking history, Killip class > II, LVEF ≤40%, D-to-B time >90 min, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease.</p>\",\"PeriodicalId\":12477,\"journal\":{\"name\":\"Frontiers in Physiology\",\"volume\":\"16 \",\"pages\":\"1514585\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014560/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Physiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fphys.2025.1514585\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PHYSIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fphys.2025.1514585","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在系统回顾经皮冠状动脉介入治疗（PCI）的冠心病患者主要不良心血管事件（MACE）的危险因素。设计：系统回顾和荟萃分析。数据来源：Cochrane图书馆、PubMed、Web of Science、中国知网（CNKI）、万方数据库、中国科技期刊VIP数据库筛选至2024年12月。研究入选标准：对行PCI的冠心病患者发生MACE危险因素的病例对照研究或队列研究。数据提取与综合：由2名独立研究者进行文献综述、数据提取和质量评价，meta分析采用RevMan 5.4软件。主要结局：主要结局为随访期间MACE发生情况。结果：共纳入文献40篇。荟萃分析显示，血脂异常(OR = 1.50；95% CI [1.19, 1.89], p = 0.0007)，糖尿病(OR = 1.70；95% CI [1.43, 2.02], p < 0.00001)，高血压(OR = 1.62；95% CI [1.35, 1.96], p < 0.0001)、吸烟史(OR = 2.08；95% CI [1.51, 2.85], p < 0.0001)，心室功能较差(OR = 2.39；95% CI [2.17-2.64], p < 0.0001)，左室射血分数（LVEF）受损(OR = 1.86；95% CI [1.71-2.03], p < 0.0001)，门到球囊（D-to-B）时间(OR = 0.61；95% ci [0.42-0.88]；p = 0.009)，心肌梗死溶栓（TIMI） (OR = 1.41；95% CI [1.17, 1.70], p = 0.0004)，肾功能不全(OR = 1.82；95% CI [1.37, 2.43], p < 0.0001)和多支冠状动脉疾病(OR = 0.41；95% CI [0.37, 0.46], p < 0.0001)与PCI术后MACE显著相关。结论：PCI术后MACE的独立危险因素为血脂异常、高血压、糖尿病、吸烟史、Killip分级>ⅱ、LVEF≤40%、D-to-B时间>90 min、TIMI血流分级≤ⅱ、肾功能不全、多血管病变。
A Systematic Review of risk factors for major adverse cardiovascular events in patients with coronary heart disease who underwent percutaneous coronary intervention.
Objective: This study aims to systematically review the risk factors for major adverse cardiovascular events (MACE) in patients with coronary heart disease who have undergone percutaneous coronary intervention (PCI).
Design: Systematic review and meta-analysis.
Data sources: The Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese Technical Periodicals (VIP) were screened until December 2024.
Eligibility criteria for selecting studies: Case-control studies or cohort studies on the risk factors for MACE in patients with coronary heart disease who underwent PCI. Data extraction and synthesis: The literature review, data extraction, and quality evaluation were conducted by two independent researchers, and the meta-analysis was performed using RevMan 5.4 software.
Main outcomes: The main outcome was that MACE occurred during the follow-up period.
Results: A total of 40 articles were included. The meta-analysis erevealed that dyslipidemia (OR = 1.50; 95% CI [1.19, 1.89], p = 0.0007), diabetes mellitus (OR = 1.70; 95% CI [1.43, 2.02], p < 0.00001), hypertension (OR = 1.62; 95% CI [1.35, 1.96], p < 0.0001), history of smoking (OR = 2.08; 95% CI [1.51, 2.85], p < 0.0001), poorer ventricular function (OR = 2.39; 95% CI [2.17-2.64], p < 0.0001), impaired left ventricular ejection fraction (LVEF) (OR = 1.86; 95% CI [1.71-2.03], p < 0.0001), door to balloon (D-to-B) time (OR = 0.61; 95% CI [0.42-0.88]; p = 0.009), thrombolysis in myocardial infarction (TIMI) (OR = 1.41; 95% CI [1.17, 1.70], p = 0.0004), renal dysfunction (OR = 1.82; 95% CI [1.37, 2.43], p < 0.0001), and multi-vessel coronary artery disease (OR = 0.41; 95% CI [0.37, 0.46], p < 0.0001) were significantly associated with MACE after PCI.
Conclusion: The independent risk factors of MACE after PCI are dyslipidemia, hypertension, diabetes mellitus, smoking history, Killip class > II, LVEF ≤40%, D-to-B time >90 min, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease.
期刊介绍：
Frontiers in Physiology is a leading journal in its field, publishing rigorously peer-reviewed research on the physiology of living systems, from the subcellular and molecular domains to the intact organism, and its interaction with the environment. Field Chief Editor George E. Billman at the Ohio State University Columbus is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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