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Objective To systematically evaluate the risk factors of slow coronary blood flow in suspected CHD patients and provide a basis for clinical diagnosis and coronary hemodynamics research. Methods We searched PubMed, Web of Science, The Cochrane Libraray, CNKI and WanFang Data from inception to September 1st 2020 to collect case-control studies about slow coronary flow in suspected CHD patients. Meta -analysis and heterogeneity test were performed for the included studies using RevMan 5.4 software. Results Nineteen studies involving 2 597 CSF patients and 2 342 controls were finally included, including 12 in Chinese and 7 in English. The included studies were population-based cross-sectional studies or case-control studies. A total of 14 risk factors were included after the exclusion of factors with high heterogeneity. The results of Meta -analysis showed that: male (OR=1.43, 95%CI 1.09 to 1.87, P= 0.009), red blood count (MD=0.45, 95%CI 0.23 to 0.68, P < 0.000 1), hematocrit (MD=3.45, 95%CI 2.38 to 4.52, P < 0.001), mean platelet volume (MD=0.46, 95%CI 0.06 to 0.86, P= 0.02), serum uric acid (SMD=1.58, 95%CI 0.39 to 2.76, P= 0.009), homocysteine (SMD=2.54, 95%CI 1.50 to 3.58, P < 0.001),high-density lipoprotein (SMD=-0.76, 95%CI -1.12 to -0.39, P < 0.001), the difference was statistically significant (P < 0.05). Conclusions Based on the existing evidence, the risk factors of slow coronary blood flow in suspected CHD patients include male, red blood cell count, hematocrit, mean platelet volume, serum uric acid, homocysteine and high density lipoprotein is an independent protective factor. The results showed that male patients, intravascular inflammatory response and blood viscosity were important factors affecting slow coronary flow.
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