biostudies-literatureKelshiker MABritish Heart FoundationM.J.S.-S.Medical Research CouncilNational Institute for Health Research (NIHR)M.F.National Insitute for Health Research AcademyWellcome TrustD.F.R.P.C.A.R.1582-1593https://www.ebi.ac.uk/biostudies/studies/S-EPMC9020988biostudies-literatureUnknown43(16)<h4>Aims</h4>This meta-analysis aims to quantify the association of reduced coronary flow with all-cause mortality and major adverse cardiovascular events (MACE) across a broad range of patient groups and pathologies.<h4>Methods and results</h4>We systematically identified all studies between 1 January 2000 and 1 August 2020, where coronary flow was measured and clinical outcomes were reported. The endpoints were all-cause mortality and MACE. Estimates of effect were calculated from published hazard ratios (HRs) using a random-effects model. Seventy-nine studies with a total of 59 740 subjects were included. Abnormal coronary flow reserve (CFR) was associated with a higher incidence of all-cause mortality [HR: 3.78, 95% confidence interval (CI): 2.39-5.97] and a higher incidence of MACE (HEuropean heart journalCoronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis.PMC9020988FS 04/079212183/Z/18/ZFS/11/46/28861214567/Z/18/ZMR/S021108/1CL-2020-21-004NIHR300166MR/V001620/1FS/14/25/30676FS/14/27/30752CL-2018-21-001PG/15/7/31235Al-Lamee RShun-Shin MJHoward JPPetraco RSeligman HNowbar ANRajkumar CAAhmad YRahman HFoley MKelshiker MASen SfalseCoronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis.<h4>Aims</h4>This meta-analysis aims to quantify the association of reduced coronary flow with all-cause mortality and major adverse cardiovascular events (MACE) across a broad range of patient groups and pathologies.<h4>Methods and results</h4>We systematically identified all studies between 1 January 2000 and 1 August 2020, where coronary flow was measured and clinical outcomes were reported. The endpoints were all-cause mortality and MACE. Estimates of effect were calculated from published hazard ratios (HRs) using a random-effects model. Seventy-nine studies with a total of 59 740 subjects were included. Abnormal coronary flow reserve (CFR) was associated with a higher incidence of all-cause mortality [HR: 3.78, 95% confidence interval (CI): 2.39-5.97] and a higher incidence of MACE (H2022-01-01T00:00:00Z2022 Apr2025-06-01T03:50:01.378Z2024-11-19T15:00:57.35ZS-EPMC90209883484969710.1093/eurheartj/ehab775