Objective The influencing factors of the stability of coronary atherosclerotic plaques were explored through meta-analysis. Methods Seven databases at home and abroad were searched, and the search time limit was from the establishment of the database to August 5, 2025. The research literature on the influencing factors of plaque stability in Chinese patients with coronary atherosclerosis was screened. According to the inclusion and exclusion criteria, the literature was screened, the data was extracted, and the quality was evaluated. Nine influencing factors were collected, including age, smoking, life event stress history, depression, low-density lipoprotein cholesterol (LDL-C) level, total cholesterol (TC), uric acid (UA), C-reactive protein (CRP), cystatin C (CysC). Stata 18.0 and Review Manager 5.4 software were used to conduct Meta-analysis according to the results of heterogeneity test using random effect model or fixed effect model. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated, and sensitivity analysis and subgroup analysis were performed. Results A total of 7 high-quality studies involving 3 523 patients were included. The results of Meta-analysis showed that age (OR=1.04, 95% CI: 1.00-1.07), smoking (OR=3.36, 95% CI: 2.18-5.18), life events stress history (OR=1.03, 95% CI: 1.02-1.04), depression (OR=1.17, 95% CI: 1.11-1.22), LDL-C level (OR=2.74, 95% CI: 2.01-3.72), UA level (OR=3.54, 95% CI: 2.15-5.83), CRP level (OR=1.49, 95% CI: 1.18-1.89) and CysC level (OR=3.18, 95% CI: 2.06-4.90) were risk factors for plaque stability (all P<0.05). However, TC level was not significantly associated with plaque stability (OR=0.90, 95% CI: 0.63-1.29, P=0.568). The analysis results of smoking, LDL-C, UA and CysC showed low heterogeneity and good robustness. Conclusion Smoking, high UA, high LDL-C, high cystatin C, high CRP levels, as well as a history of life event stress, depression and aging are important risk factors for plaque stability in Chinese patients with coronary atherosclerosis.
Key words
coronary atherosclerosis /
plaque stability /
influencing factors /
meta-analysis
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