Evaluating risk factors of embolism in patients with cardiac myxoma: A systematic review and meta-analysis
Abstract Body (Do not enter title and authors here): Background Risk stratification for embolism in cardiac myxomas remains poorly explored.
Goals By this meta-analysis we studied the risk factors assicated with embolism among patients with cardiac myxoma.
Methods A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Google Scholar from their inception until January 2024. 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.
Results We included 18 studies in our analysis with a total population of 2601 out of which 525 patients (20.1%) had at least one episode of embolism. The pooled analyses showed that hypertension (p = 0.001), New York Heart Association I/II (p = 0.03), irregular tumor surface (p <0.00001), hyperlipidemia (p < 0.0001), coronary artery disease (p=0.01), high mean platelet volume (p=0.02), high tumor mobility (p<0.00001), were significantly associated with increased incidence of embolism. Female gender (p = 0.03) was the only risk factor associated with reduced risk. Other factors like smoking, atrial fibrillation, tumor size, age, body mass index (BMI), diabetes, left ventricular ejection fraction (LVEF), left atrial diameter (LAD) were not significantly associated with embolism (p > 0.05).
Conclusion Our study is the first to report significant pooled outcomes for gender, hyperlipidemia, coronary artery disease, mean platelet volume, and tumor mobility in the population discussed. Hypertension, New York Heart Association I/II, irregular tumor surface, hyperlipidemia, coronary artery disease, mean platelet volume and tumor mobility were significantly associated with high risk while female gender was associated with low risk of embolism. Patients with high-risk factors might benefit from early evaluation and definitive treatment (surgery).
Qureshi, Muhammad Ahmad
( Henry Ford Jackson Hospital
, Jackson
, Michigan
, United States
)
Hussain, Muqaddas
( King Edward Medical University
, Lahore
, Pakistan
)
Qureshi, Ali Akram
( King Edward Medical University
, Lahore
, Pakistan
)
Bakht, Danyal
( King Edward Medical University
, Lahore
, Pakistan
)
Ahmed, Omair
( Henry Ford Jackson Hospital
, Jackson
, Michigan
, United States
)
Haseeb, Shahan
( Northwell health
, Port Jefferson
, New York
, United States
)
Gupta, Kartik
( Henry Ford Hospital
, Detroit
, Michigan
, United States
)
Baqal, Omar
( Mayo Clinic
, PHOENIX
, Arizona
, United States
)
Hadeed Khawar, Mirza Muhammad
( King Edward Medical University
, Lahore
, Pakistan
)
Amir, Maaz
( King Edward Medical University
, Lahore
, Pakistan
)
Ali, Khawar
( King Edward Medical University
, Lahore
, Pakistan
)
Author Disclosures:
Muhammad Ahmad Qureshi:DO NOT have relevant financial relationships
| Muqaddas Hussain:DO NOT have relevant financial relationships
| Ali Akram Qureshi:DO NOT have relevant financial relationships
| Danyal Bakht:DO NOT have relevant financial relationships
| Omair Ahmed:DO NOT have relevant financial relationships
| Shahan Haseeb:DO NOT have relevant financial relationships
| Kartik Gupta:DO NOT have relevant financial relationships
| Omar Baqal:DO NOT have relevant financial relationships
| Mirza Muhammad Hadeed khawar:No Answer
| Maaz Amir:DO NOT have relevant financial relationships
| Khawar Ali:DO NOT have relevant financial relationships