Khandait Harshwardhan, Jaiswal Vikash, Hanif Muhammad, Shrestha Abhigan Babu, Iturburu Alisson, Shah Maitri, Ishak Angela, Garimella Vamsi, Ang Song Peng, Mathew Midhun
Trinitas Regional Medical Center/RWJ Barnabas Health, Elizabeth, NJ 07202, USA.
Department of Research, JCCR Cardiology Research, Varanasi 221005, India.
J Cardiovasc Dev Dis. 2023 Feb 21;10(3):92. doi: 10.3390/jcdd10030092.
There is a paucity of data and minimal literature on outcomes of percutaneous coronary intervention (PCI) among liver cirrhosis patients. Therefore, we conducted a systematic review and meta-analysis to evaluate the clinical outcomes among liver cirrhosis patients post-PCI. We conducted a comprehensive literature search in the PubMed, Embase, Cochrane, and Scopus databases for relevant studies. Effect sizes were pooled using the DerSimonian and Laird random-effects model as an odds ratio (OR) with 95% confidence intervals (CI). A total of 3 studies met the inclusion criteria, providing data from 10,705,976 patients. A total of 28,100 patients were in the PCI + Cirrhosis group and 10,677,876 patients were in the PCI-only group. The mean age of patients with PCI + Cirrhosis and PCI alone was 63.45 and 64.35 years. The most common comorbidity was hypertension among the PCI + Cirrhosis group compared with PCI alone (68.15% vs. 73.6%). Cirrhosis patients post-PCI were had higher rates of in-hospital mortality (OR, 4.78 (95%CI: 3.39-6.75), < 0.001), GI bleeding (OR, 1.91 (95%CI:1.83-1.99), < 0.001, I = 0%), stroke (OR, 2.48 (95%CI:1.68-3.66), < 0.001), AKI (OR, 3.66 (95%CI: 2.33-6.02), < 0.001), and vascular complications (OR, 1.50 (95%CI: 1.13-1.98), < 0.001) compared with the PCI group without cirrhosis. Patients with cirrhosis are at a high risk for mortality and adverse outcomes post-PCI procedure compared to the PCI-only group of patients.
关于肝硬化患者经皮冠状动脉介入治疗（PCI）的结局，现有数据匮乏且相关文献极少。因此，我们进行了一项系统评价和荟萃分析，以评估肝硬化患者PCI术后的临床结局。我们在PubMed、Embase、Cochrane和Scopus数据库中进行了全面的文献检索，以查找相关研究。效应量采用DerSimonian和Laird随机效应模型合并，以比值比（OR）及95%置信区间（CI）表示。共有3项研究符合纳入标准，提供了来自10705976例患者的数据。PCI+肝硬化组共有28100例患者，单纯PCI组有10677876例患者。PCI+肝硬化组和单纯PCI组患者的平均年龄分别为63.45岁和64.35岁。与单纯PCI组相比，PCI+肝硬化组最常见的合并症是高血压（68.15%对73.6%）。与无肝硬化的PCI组相比，PCI术后的肝硬化患者院内死亡率更高（OR，4.78（95%CI：3.39 - 6.75），<0.001）、消化道出血发生率更高（OR，1.91（95%CI：1.83 - 1.99），<0.001，I = 0%）、卒中发生率更高（OR，2.48（95%CI：1.68 - 3.66），<0.001）、急性肾损伤发生率更高（OR，3.66（95%CI：2.33 - 6.02），<0.001）以及血管并发症发生率更高（OR，1.50（95%CI：1.13 - 1.98），<0.001）。与单纯PCI组患者相比，肝硬化患者PCI术后死亡和不良结局的风险更高。
