Key result
Irregular cardiac myxoma surface is linked to ~299% higher embolism risk versus regular surface.
Why the study?
The risk factors contributing to embolism in cardiac myxoma remain controversial.
Meta-Analysis (n=1,814)
Effect estimate: OR 3.99 (95% CI 3.04-5.25)
p-value: p=<0.01
NYHA class I/II, hypertension, irregular tumor surface, atypical tumor location, narrow tumor base, and increased fibrinogen are significant risk factors for embolism in cardiac myxoma patients, suggesting early surgery may be beneficial for this high-risk group.
May support expedited resection for irregular-surface myxomas; extends observational meta-analyses but leaves timing questions open.
BACKGROUND: The risk factors contributing to embolism in cardiac myxoma (CM) are yet controversial. This systematic review and meta-analysis aimed to clarify the risk factors of embolism for the CM patients. METHODS: PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wan Fang, and Wei Pu databases were searched from inception to June 2019. Statistical analysis was conducted using Stata version 14.0. The pooled odds ratio or mean difference with 95% confidence interval was estimated for each risk factor. RESULTS: Herein, 12 studies, encompassing 1814 patients, were included. The pooled results suggested that New York Heart Association (NYHA) class I/II (P < 0.01), hypertension (P = 0.03), irregular tumor surface (P < 0.01), tumor in atypical location (P = 0.01), narrow base of tumor (P < 0.01), and increased fibrinogen (FIB) (P < 0.01) are significant risk factors of embolism in CM patients. However, sex, age, body mass index, smoking, left ventricular ejection fraction, diabetes, hyperlipidemia, atrial fibrillation, valvular heart disease, coronary heart disease, tumor size, platelet count, white blood cells, and hemoglobin were not associated with embolism (all P > 0.05). CONCLUSIONS: NYHA class (I/II), hypertension, irregular tumor surface, atypical tumor location, the narrow base of tumor, and increased FIB were significant risk factors of embolism in CM patients. For CM patients with these factors, early surgery might be beneficial to prevent embolism.
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Liu et al. (2020) conducted a meta-analysis in Cardiac myxoma (n=1,814). Irregular tumor surface vs. Regular tumor surface was evaluated on Embolism (OR 3.99, 95% CI 3.04-5.25, p=<0.01). Irregular tumor surface significantly increased the risk of embolism (OR 3.99) compared to regular tumor surface in patients with cardiac myxoma.
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