What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Cardiac myxoma (n=1814). Intervention: Irregular tumor surface vs. Regular tumor surface. Primary outcome: Embolism (OR 3.99, 95% CI 3.04-5.25, p=<0.01).

July 25, 2020Open Access

Risk factors of embolism for the cardiac myxoma patients: a systematic review and metanalysis

Q: What are the key findings of this study?

Irregular tumor surface significantly increased the risk of embolism (OR 3.99) compared to regular tumor surface in patients with cardiac myxoma.

Key Result

Irregular tumor surface significantly increased the risk of embolism (OR 3.99) compared to regular tumor surface in patients with cardiac myxoma.

Study Design

Type

Meta-Analysis (n=1,814)

Structured PICO

Population

1,814 patients with cardiac myxoma (CM) who underwent surgical resection and were confirmed by pathological examination, pooled from 12 retrospective case series.

Outcome

Embolic events diagnosed by clinical symptoms or imaging examinationhard clinical

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.

Main Result

Effect estimate: OR 3.99 (95% CI 3.04-5.25)

p-value: p=<0.01

Limitations

All enrolled studies were retrospective case series, making residual confounders and unidentified factors inevitable.
All included studies originated from Asia, which might lead to selection bias.
The number of overlapped risk factors in each of the studies was small for a comprehensive statistical analysis.
High heterogeneity was observed in the data for tumor size.

Abstract

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 0.05). 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.

Bookmark

View Full Paper