April 9, 2025Frontiers in Physiology9 citationsOpen Access

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

YZYou ZhaiJilin University HSHongcai ShangBeijing University of Chinese Medicine YLYan LiShihezi University

Structured PICO

What are the independent risk factors for major adverse cardiovascular events in patients with coronary heart disease who underwent percutaneous coronary intervention?

Population

Patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) from 40 included case-control or cohort studies.

Intervention

Presence of clinical and procedural risk factors (dyslipidemia, diabetes mellitus, hypertension, smoking history, Killip class > II, LVEF ≤40%, D-to-B time >90 min, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease)

Comparator

Absence of these risk factors

Outcome

Major adverse cardiovascular events (MACE) during the follow-up periodcomposite

Dyslipidemia, hypertension, diabetes, smoking, Killip class > II, LVEF ≤40%, D-to-B time >90 min, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease are independent risk factors for MACE after PCI.

Abstract

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.

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