Long-Term Outcomes of Complete Versus Incomplete Revascularization for Patients with Multivessel Coronary Artery Disease and Left Ventricular Systolic Dysfunction in Drug-Eluting Stent Era.
10.3346/jkms.2014.29.11.1501
- Author:
Gwan Hyeop SOHN
1
;
Jeong Hoon YANG
;
Seung Hyuk CHOI
;
Young Bin SONG
;
Joo Yong HAHN
;
Jin Ho CHOI
;
Hyeon Cheol GWON
;
Sang Hoon LEE
Author Information
1. Division of Cardiology, Department of Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
- Publication Type:Original Article
- Keywords:
Drug-Eluting Stents;
Left Ventricular Systolic Dysfunction;
Revascularization
- MeSH:
Age Factors;
Aged;
Coronary Artery Disease/*drug therapy/mortality/physiopathology;
Diabetes Mellitus, Type 2/complications;
*Drug-Eluting Stents;
Female;
Follow-Up Studies;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Myocardial Infarction/etiology;
Myocardial Revascularization;
Percutaneous Coronary Intervention/adverse effects;
Proportional Hazards Models;
Renal Insufficiency, Chronic/complications;
Retrospective Studies;
Sex Factors;
Treatment Outcome;
Ventricular Dysfunction, Left/physiopathology
- From:Journal of Korean Medical Science
2014;29(11):1501-1506
- CountryRepublic of Korea
- Language:English
-
Abstract:
We aimed to investigate that complete revascularization (CR) would be associated with a decreased mortality in patients with multivessel disease (MVD) and reduced left ventricular ejection fraction (LVEF). We enrolled a total of 263 patients with MVD and LVEF <50% who had undergone percutaneous coronary intervention with drug-eluting stent between March 2003 and December 2010. We compared major adverse cardiac and cerebrovascular accident (MACCE) including all-cause death, myocardial infarction, any revascularization, and cerebrovascular accident between CR and incomplete revascularization (IR). CR was achieved in 150 patients. During median follow-up of 40 months, MACCE occurred in 52 (34.7%) patients in the CR group versus 51 (45.1%) patients in the IR group (P=0.06). After a Cox regression model with inverse-probability-of-treatment-weighting using propensity score, the incidence of MACCE of the CR group were lower than those of the IR group (34.7% vs. 45.1%; adjusted hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.44-0.95, P=0.03). The rate of all-cause death was significantly lower in patients with CR than in those with IR (adjusted HR, 0.48; 95% CI, 0.29-0.80, P<0.01). In conclusion, the achievement of CR with drug-eluting stent reduces long-term MACCE in patients with MVD and reduced LVEF.
