Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis.
Harshwardhan KhandaitVikash JaiswalMuhammad HanifAbhigan Babu ShresthaAlisson IturburuMaitri ShahAngela IshakVamsi GarimellaSong Peng AngMidhun MathewPublished in: Journal of cardiovascular development and disease (2023)
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), p < 0.001), GI bleeding (OR, 1.91 (95%CI:1.83-1.99), p < 0.001, I 2 = 0%), stroke (OR, 2.48 (95%CI:1.68-3.66), p < 0.001), AKI (OR, 3.66 (95%CI: 2.33-6.02), p < 0.001), and vascular complications (OR, 1.50 (95%CI: 1.13-1.98), p < 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.
Keyphrases
- percutaneous coronary intervention
- end stage renal disease
- acute coronary syndrome
- coronary artery disease
- acute myocardial infarction
- newly diagnosed
- antiplatelet therapy
- chronic kidney disease
- ejection fraction
- st segment elevation myocardial infarction
- atrial fibrillation
- prognostic factors
- clinical trial
- cardiovascular disease
- type diabetes
- peritoneal dialysis
- skeletal muscle
- metabolic syndrome
- left ventricular
- coronary artery bypass grafting
- electronic health record
- machine learning
- blood pressure
- risk factors
- adipose tissue
- acute kidney injury
- coronary artery bypass
- insulin resistance
- tyrosine kinase
- subarachnoid hemorrhage
- glycemic control