Qureshi Muhammad Ahmad, Bakht Danyal, Ahmed Omair, Haseeb Shahan, Gupta Kartik, Baqal Omar, Amir Maaz, Ali Khawar, Khawar Mirza Muhammad Hadeed, Hussain Muqaddas, Munir Luqman, Othman Hussein
Henry Ford Jackson Hospital, Jackson, MI, USA.
King Edward Medical University, Lahore, Punjab, Pakistan.
Am Heart J Plus. 2025 May 29;56:100559. doi: 10.1016/j.ahjo.2025.100559. eCollection 2025 Aug.
Cardiac myxomas (CM), the most common primary cardiac tumors, can cause embolism in about 40 % of cases, making it crucial to identify risk factors for guiding clinical decisions.
In this meta-analysis, we studied the risk factors associated with embolism among patients with cardiac myxomas.
A comprehensive search was conducted across PubMed, Embase, and Cochrane Library from their inception until May 2023. Statistical analyses were performed using Cochrane's RevMan 5.4 software. For each risk factor, the pooled odds ratio or mean difference was calculated along with the corresponding 95 % confidence interval.
This meta-analysis incorporated 18 studies with 2601 patients, of whom 525 (20.1 %) experienced embolism. Significant risk factors included hypertension ( = 0.001), NYHA I/II ( = 0.03), irregular tumor surface ( < 0.01), hyperlipidemia (p < 0.01), coronary artery disease ( = 0.01), elevated mean platelet volume ( = 0.02), and high tumor mobility (p < 0.01), while female gender (p = 0.03) was linked to reduced risk. Smoking, atrial fibrillation, tumor size, age, BMI, diabetes, LVEF, and LAD were not significantly associated with embolism ( > 0.05).
This analysis is the first to highlight significant pooled outcomes for gender, hyperlipidemia, coronary artery disease, mean platelet volume, and tumor mobility. Patients with these risk factors may benefit from early evaluation and surgery to reduce embolism risk. Statistical analyses were performed using RevMan 5.4, with pooled odds ratios or mean differences calculated alongside 95 % confidence intervals.
心脏黏液瘤（CM）是最常见的原发性心脏肿瘤，约40%的病例会发生栓塞，因此识别风险因素以指导临床决策至关重要。
在这项荟萃分析中，我们研究了心脏黏液瘤患者发生栓塞的相关风险因素。
从创刊至2023年5月，在PubMed、Embase和Cochrane图书馆进行了全面检索。使用Cochrane的RevMan 5.4软件进行统计分析。对于每个风险因素，计算合并比值比或平均差以及相应的95%置信区间。
这项荟萃分析纳入了18项研究，共2601例患者，其中525例（20.1%）发生了栓塞。显著的风险因素包括高血压（p = 0.001）、纽约心脏协会心功能I/II级（p = 0.03）、肿瘤表面不规则（p < 0.01）、高脂血症（p < 0.01）、冠状动脉疾病（p = 0.01）、平均血小板体积升高（p = 0.02）和肿瘤活动度高（p < 0.01），而女性（p = 0.03）与风险降低有关。吸烟、心房颤动、肿瘤大小、年龄、体重指数、糖尿病、左心室射血分数和左心房内径与栓塞无显著相关性（p > 0.05）。
本分析首次突出了性别、高脂血症、冠状动脉疾病、平均血小板体积和肿瘤活动度的显著合并结果。有这些风险因素的患者可能受益于早期评估和手术，以降低栓塞风险。使用RevMan 5.4进行统计分析，计算合并比值比或平均差以及95%置信区间。
