Meta Analysis Of Risk Factors Related To Slow Flow Of Coronary Artery

Objective:To evaluate potential risk factors for coronary slow flow phenomenon(CSFP)by a systematic review and meta-analyses.To provide reference for the prevention,diagnosis and treatment of CSFP。Methods:We searched Embase,PubMed,Cochrane,Web of Knowledge,FDA.gov,and Clinical Trials.gov systematically for articles on ’humans’ published between January 1st1972 and August 1st 2017,used the combined text and MeSH terms: “slow coronary flow phenomenon” and “risk factors”.A total of 6163 participants were analyzed,including CSFP patients(n = 2737)and control group(n = 3426).Use Stata(12.0 version)to perform Meta analysis.The quality of the literature was evaluated by Newcastle-Ottawa Quality Assessment scale.It has been registered at International Prospective Register of Systematic Reviews(PROSPERO)(number CRD42017064963).Results:(1)Compared with controls,patients with validated CSFP were characterized by hypertension(OR =1.19,95%CI:1.03~1.39,P=0.019),male gender(OR=1.43,95%CI:1.25~1.65,P<0.001),lower HDL-cholesterol level(SMD=-0.21,95%CI:-0.30~-0.13,P=0.023),higher neutrophil count(SMD=0.28,95%CI:0.08~0.48,P<0.001),higher smoking rate(OR= 1.64,95%CI:1.36~1.98,P<0.001),older age(SMD=0.12,95%CI:(0.00,0.23),P<0.001),higher body mass index(SMD=0.38,95%CI:0.18~0.59,P<0.001),higer creatinine level(SMD=-0.27,95%CI:0.11~0.43,P<0.001),higher triglyceride level(SMD=-0.15,95%CI:0.02~-0.29,P<0.001),higher white blood cell count(SMD=0.1,95%CI:0.01~0.19,P=0.004),higher hematocrit(SMD=0.27,95%CI : 0.02~0.52,P < 0.001),higher platelet count(SMD=-0.18,95%CI:0.02~0.34,P<0.001),higher mean platelet volume(fL)(SMD=0.7,95%CI:0.15~0.24,P<0.001),and higher hs-CRP,(SMD=0.95,95%CI:0.56~1.35,P<0.001),hemoglobin(SMD=-0.28,95%CI:0.16~0.40,P<0.0001).(2)CSFP was not associated with diabetes,hyperlipemia,uric acid,diastolic blood pressure,systolic blood pressure,urea,EF%,fasting blood glucose,heart rate,LDL-cholesterol,red cell distribution width,total cholesterol or lymphocyte count.Conclusion:(1)The Meta-analysis showed that CSFP was a disease caused by a variety of risk factors.The risk factors closely related to it were male,hypertension,HDL-cholesterol,high smoking rate,white blood cell count,hemoglobin increased,senile,neutrophil count,blood cell specific volume,triglyceride,creatinine increased,platelet count increased,hypersensitive C-reactive protein increased,body weight index increased,and average platelet volume increased.(2)The results of Meta analysis showed that the common risk factors of coronary heart disease were diabetes,fasting blood glucose,uric acid,urea,LDL-cholesterol and total cholesterol were not correlated with CSFP.The decrease of HDL-cholesterol and the increase of triglyceride are more important risk factors in CSFP patients.Therefore,we speculate that the pathogenesis of CSFP may be different from the traditional pathogenesis of coronary heart disease and need further study to elucidate the pathogenesis of CSFP.