A Systematic Review of risk factors for major adverse cardiovascular events in patients with coronary heart disease who underwent percutaneous coronary intervention.

Abstract

<h4>Objective</h4>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).<h4>Design</h4>Systematic review and meta-analysis.<h4>Data sources</h4>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.<h4>Eligibility criteria for selecting studies</h4>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.<h4>Main outcomes</h4>The main outcome was that MACE occurred during the follow-up period.<h4>Results</h4>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.<h4>Conclusion</h4>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.