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Fig 1.

Flowchart of the study selection process using PRISMA tool.

CMVD = coronary microvascular dysfunction; MACE = Major Adverse Cardiovascular Events; CABG = Coronary artery bypass graft; CAD = coronary artery disease.

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Table 1.

General characteristics of included studies.

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Fig 2.

Quality of included studies using QUIPS tool.

QUIPS = Quality in Prognostic Studies.

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Fig 3.

Forest plot of MACE with and without severe CMVD.

CMVD was significantly associated with an increased risk of MACE, with a pooled HR of 3.42 [2.45; 4.79]. Squares and diamonds = hazard ratios, lines = 95% CI. TE = treatment effect; SE = standard errors; MACE = Major Adverse Cardiovascular Events; CMVD = coronary microvascular dysfunction; CI = confidence interval.

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Fig 4.

Sensitivity analyses.

Sensitivity analyses consisted in repeating the forest plot after removing 3 studies at high risk of bias.

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Fig 5.

GRADE framework.

Quality of evidence using GRADE framework adapted to prognostic factor studies. GRADE = Grading of Recommandations, Assessment, Development and Evaluations.

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Fig 6.

Funnel plot.

The funnel plot showed no asymmetry, suggesting no publication biais.

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