Pooled prevalence of three major cardiovascular risk factors in patients undergoing left main bifurcation stenting: a systematic review and meta-analysis.

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.