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Pooled prevalence of three major cardiovascular risk factors in patients undergoing left main bifurcation stenting: a
Gianluca Rigatelli1, Marco Zuin2, Dobrin Vassilev3
1Section of Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy - jackyheart@libero.it.
Insights
Major cardiovascular risk factors like hypertension, hyperlipidemia, and diabetes are common in Left Main bifurcation disease patients. Hypertension is most prevalent in severe cases requiring two-stent procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Left Main (LM) bifurcation disease is a critical condition.
- Prevalence of major cardiovascular risk factors in LM bifurcation disease patients is not well-established.
- Understanding these risk factors is crucial for developing computational models.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of three major cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus) in patients treated for LM bifurcation disease.
- To compare the prevalence of these risk factors between single-stent and two-stent strategies.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Searched Cochrane Library, Embase, PubMed, and Google Scholar for studies published between January 2015 and October 2020.
- Included studies comparing single- versus two-stent strategies for LM bifurcation disease and reporting prevalence of hypertension (HT), hyperlipidemia (HyperL), and diabetes mellitus (DM).
Main Results:
- Seven studies with 4559 patients (2666 single-stent, 1933 two-stent) were included.
- Pooled prevalence: HT 69.4%, HyperL 38.9%, DM 31%.
- HT prevalence was lower in single-stent vs. two-stent (63% vs. 66.7%, P=0.01). HyperL and DM were more prevalent in single-stent vs. two-stent (41.6% vs. 34.1%, P<0.001 for HyperL; 32.5% vs. 31.8%, P=0.61 for DM).
Conclusions:
- Hypertension, hyperlipidemia, and diabetes mellitus are frequent comorbidities in patients with LM bifurcation disease, regardless of stenting strategy.
- Hypertension is the most prevalent risk factor in severe LM disease requiring a two-stent technique.
Introduction:
Prevalence of the major risk factors in patients with Left Main (LM) bifurcation disease has not been yet clearly assessed, although it would be important for building up bifurcation computational models. We perform a systematic review and meta-analysis on the three major cardiovascular risk factors in patients treated for LM bifurcation disease using either single or two-stent strategy.
Eveidence Acquisition:
In accordance with the PRISMA guidelines, Cochrane Library, Embase, PubMed and Google Scholar were queried to locate articles published between January 2015 to October 2020, comparing single- versus two-stent strategy and reporting the prevalence of arterial hypertension (HT), hyperlipidemia (HyperL) and diabetes mellitus (DM).
Evidence Synthesis:
Out of a total of 230 articles, seven articles were included into the final analysis. A total of 4559 patients were enrolled: 2666 (58.4%, mean age 60.4 years, 2318 males) and 1933 patients (42.3%, mean age 64.8 years, 1763 males) received a single- and two-stent stenting strategies, respectively. A random effect model revealed a pooled prevalence of HT, HyperL and DM in 69.4%, 38.9% and in 31% of cases, respectively. Prevalence of HT was lower in patients treated with single versus two-stent strategy (63 versus 66.7% of patients, P=0.01) while HyperL and DM were more represented in single versus two-stent strategy: 41.6 versus 34.1% (P<0.001), and 32.5 versus 31.8% of patients (P=0.61), respectively.
Conclusions:
In patients with LM bifurcation disease undergoing either single or two-stent strategy, HT, HyperL and DM are frequent comorbidities. In severe LM disease requiring two-stent technique, HT is the most prevalent risk factor.
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