Abstract
BACKGROUND: Despite the unknown mechanisms of coronary slow flow (CSF), several studies have investigated the role of inflammation in CSF pathogenesis and evaluated the hs-CRP levels in these patients. Our meta-analysis aims to resolve the controversy in the results and draw a conclusion. METHODS: All studies measuring hs-CRP in patients with CSF and controls were included after a systematic search. A random-effects meta-analysis was employed to calculate standardized mean differences, considering heterogeneity among the studies. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Out of the 299 records, 31 cross-sectional studies were included in the systematic review. The meta-analysis of these eligible cross-sectional studies revealed a significant association between CSF and hs-CRP (MD: 1.95 mg/L; 95% CI, 1.03 to 2.88; p ≤ 0.0001). The heterogeneity was considerable among studies. Additionally, sensitivity analyses indicated that the meta-analysis models were robust. CONCLUSION: This meta-analysis suggests that patients with CSF exhibit significantly elevated hs-CRP levels compared to healthy controls, supporting the role of hs-CRP as a state marker of the disease. SYSTEMATIC REVIEW REGISTRATION: CRD42023359516.