Distribution of traditional Chinese medicine pattern types and prognostic risk factors in patients undergoing percutaneous coronary intervention (PCI): a systematic review and meta-analysis

Objective

To clarify the distribution of traditional Chinese medicine (TCM) pattern and its associated risk factors after percutaneous coronary intervention (PCI), and evaluate the reporting quality of existing studies to guide future research standardization.

Methods

English databases including PubMed, Cochrane Library, and Web of Science, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (VIP), and Wanfang Database were searched to retrieve papers about PCI. The time span for the paper retrieval was set from the foundation of the databases to October 1, 2023. Statistical analyses were performed using Stata 12 and Python (V 3.9). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was used to assess the reporting quality of included studies.

Results

Overall, 1 356 articles were selected, and 40 cross-sectional studies were included with 10 270 participants. The most common TCM patterns before, one to two weeks after, and six months to one year after PCI was Qi stagnation and blood stasis (n = 261, 36.45%), intertwined phlegm and blood stasis (n = 109, 27.18%), and Qi deficiency and blood stasis (n = 645, 37.03%), respectively. Smoking [odds ratio (OR) = 1.15, 95% confidence interval (CI) (0.83 – 1.47), I²= 24.7%, P = 0.257], pattern of congealing cold and Qi stagnation [OR = 4.62, 95% CI (1.37 – 7.86), I² = 61.6%, P = 0.074], and low-density lipoprotein (LDL) [OR = 1.38, 95% CI (0.92 – 1.85), I²= 12.2%, P = 0.286] were risk factors for restenosis. Hypertension [OR = 7.26, 95% CI (3.54 – 14.88), I²= 91.6%, P = 0.001], and overweight [i.e., body mass index (BMI) > 23] [OR = 1.20, 95% CI (1.07 – 1.35), I²= 85.3%, P = 0.009] were significant risk factors of concomitant anxiety.

Conclusion

This systematic review and meta-analysis revealed that patients with different TCM pattern types have distinct characteristics and risk factors after PCI. More high-quality studies are warranted to provide supportive evidence for future research and clinical practice.