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Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Harshwardhan Khandait1, Vikash Jaiswal2, Muhammad Hanif3

  • 1Trinitas Regional Medical Center/RWJ Barnabas Health, Elizabeth, NJ 07202, USA.

Journal of Cardiovascular Development and Disease
|March 28, 2023
PubMed

Insights

Patients with liver cirrhosis undergoing percutaneous coronary intervention (PCI) face significantly higher risks of in-hospital mortality, gastrointestinal bleeding, stroke, acute kidney injury, and vascular complications compared to those without cirrhosis.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Nephrology

Background:

  • Limited data exists on percutaneous coronary intervention (PCI) outcomes in liver cirrhosis patients.
  • Liver cirrhosis is a significant comorbidity that may impact cardiovascular procedure outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze clinical outcomes of PCI in patients with liver cirrhosis.
  • To compare adverse event rates between PCI patients with and without cirrhosis.

Main Methods:

  • Comprehensive literature search across PubMed, Embase, Cochrane, and Scopus.
  • Meta-analysis using a random-effects model (DerSimonian and Laird) to calculate odds ratios (OR) with 95% confidence intervals (CI).
  • Inclusion of 3 studies with data from over 10.7 million patients (28,100 with PCI + Cirrhosis, 10,677,876 with PCI alone).

Main Results:

  • Cirrhosis patients undergoing PCI had higher in-hospital mortality (OR 4.78), GI bleeding (OR 1.91), stroke (OR 2.48), acute kidney injury (AKI) (OR 3.66), and vascular complications (OR 1.50).
  • Hypertension was the most common comorbidity in the PCI + Cirrhosis group (68.15%).
  • Mean age was similar between groups (63.45 years for PCI + Cirrhosis vs. 64.35 years for PCI alone).

Conclusions:

  • Liver cirrhosis patients are at substantially increased risk for adverse outcomes and mortality post-PCI.
  • These findings highlight the need for careful risk assessment and management in cirrhotic patients undergoing PCI.

Keywords:
cirrhosiscoronary artery diseaserevascularization

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