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ORIGINAL RESEARCH article
Front. Physiol.
Sec. Vascular Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1514585
A Systematic Review of Risk Factors for Major Adverse Cardiovascular Events in Patients with Coronary Heart Disease who underwent Percutaneous Coronary Intervention
Provisionally accepted- 1 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- 2 Henan University of Chinese Medicine, Zhengzhou, Henan Province, China
- 3 First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, China
AbstractObjective: 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 revealed 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 minutes, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease.
Keywords: coronary heart disease, Percutaneous Coronary Intervention, Risk factors, Major cardiovascular adverse events, Meta-analysis
Received: 21 Oct 2024; Accepted: 28 Mar 2025.
Copyright: © 2025 Zhai, Shang, Li, Zhang, Zhang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
You Zhai, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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