INTRODUCTION The main aim of this study was to investigate the impact of isolated coronary microvascular disease (CMD) as diagnosed via various modalities on prognosis. METHOD A systematic literature review of PubMed, Embase, and Cochrane library databases was conducted to identify relevant studies published up to March 2023. Included studies were required to measure coronary microvascular function and report outcomes in patients without obstructive coronary artery disease (CAD) or any other cardiac pathological characteristics. The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiac event (MACE). Pooled effects were calculated using random-effects models. RESULTS A total of 27 studies comprising 18,204 subjects were included in the meta-analysis. Indices of coronary microvascular function measurement included coronary angiography-derived index of microcirculatory resistance (caIMR), hyperemic microcirculatory resistance (HMR), coronary flow reserve (CFR), and so on. Patients with isolated CMD exhibited a significantly higher risk of mortality (OR: 2.97, 95% CI, 1.91-4.60, P < 0.0001; HR: 3.38, 95% CI, 1.77-6.47, P = 0.0002) and MACE (OR: 5.82, 95% CI, 3.65-9.29, P＜0.00001; HR: 4.01, 95% CI, 2.59-6.20, P < 0.00001) compared to those without CMD. Subgroup analysis by measurement modality demonstrated a consistent and robust pooled effect estimates in various subgroups. CONCLUSION CMD is significantly associated with an elevated risk of mortality and MACE in patients without obstructive CAD or any other identifiable cardiac pathologies. The utilization of various measurement techniques may have potential advantages in the management of isolated CMD.

中文翻译：

---

使用各种测量方式诊断的孤立性冠状动脉微血管疾病对预后的影响：更新的系统评价和荟萃分析。

引言本研究的主要目的是调查通过各种方式诊断的孤立性冠状动脉微血管疾病（CMD）对预后的影响。方法 对 PubMed、Embase 和 Cochrane 图书馆数据库进行系统文献综述，以确定截至 2023 年 3 月发表的相关研究。纳入的研究需要测量冠状动脉微血管功能并报告没有阻塞性冠状动脉疾病 (CAD) 或任何其他疾病的患者的结果。其他心脏病理特征。主要终点是全因死亡率，次要终点是主要不良心脏事件（MACE）。使用随机效应模型计算汇总效应。结果 荟萃分析共纳入 27 项研究，涉及 18,204 名受试者。冠状动脉微血管功能测量指标包括冠状动脉造影衍生的微循环阻力指数（caIMR）、充血微循环阻力（HMR）、冠状动脉血流储备（CFR）等。孤立性 CMD 患者的死亡风险（OR：2.97，95% CI，1.91-4.60，P < 0.0001；HR：3.38，95% CI，1.77-6.47，P = 0.0002）和 MACE（OR：5.82）显着较高。 , 95% CI, 3.65-9.29, P＜0.00001; HR: 4.01, 95% CI, 2.59-6.20, P < 0.00001) 与无 CMD 的患者相比。通过测量方式进行的亚组分析证明了各个亚组中一致且稳健的汇总效应估计。结论 对于没有阻塞性 CAD 或任何其他可识别的心脏病的患者，CMD 与死亡率和 MACE 风险升高显着相关。各种测量技术的利用可能在隔离 CMD 的管理中具有潜在的优势。