Impact of depressed left ventricular function on outcomes in patients with three-vessel coronary disease undergoing percutaneous coronary intervention.
- Author:
Zhan GAO
1
;
Bo XU
;
Ajay J KIRTANE
;
Yue-jin YANG
;
Jin-qing YUAN
;
Ji-lin CHEN
;
Shu-bin QIAO
;
Yong-jian WU
;
Xue-wen QIN
;
Hong-bin YAN
;
Min YAO
;
Hai-bo LIU
;
Jue CHEN
;
Shi-jie YOU
;
Run-lin GAO
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Angioplasty, Balloon, Coronary; Coronary Disease; physiopathology; therapy; Female; Humans; Male; Middle Aged; Ventricular Function, Left; physiology
- From: Chinese Medical Journal 2013;126(4):609-614
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDPatients with multivessel coronary artery disease and depressed left ventricular ejection fraction (LVEF) represent a high risk group of patients for coronary revascularization. There are limited data on percutaneous coronary intervention treatment in this population.
METHODSAmong a cohort of 4335 patients with three-vessel disease with or without left main disease undergoing percutaneous coronary intervention, 191 patients had LVEF < 40% (low ejection fraction (EF)) and 4144 patients had LVEF ≥ 40%. In-hospital and long-term outcomes were examined according to LVEF.
RESULTSThe estimated two-year rates of major adverse cardiac events, cardiac death, and myocardial infarction were significantly higher in the low EF group (19.64% vs. 8.73%, Log-rank test: P < 0.01; 10.30% vs. 1.33%, Log-rank test: P < 0.01, and 10.32% vs. 2.28%, Log-rank test: P < 0.01 respectively), but there was no difference in the rates of target vessel revascularization (6.18% vs. 6.11%, Log-rank test: P = 0.96). Using the Cox proportional hazard models, LVEF < 40% was a significant risk factor for cardiac death, myocardial infarction, and major adverse cardiac events (OR (95%CI): 4.779 (2.369 - 9.637), 2.673 (1.353 - 5.282), and 1.827 (1.187 - 2.813) respectively), but was not a statistically significant risk factor for target vessel revascularization (OR (95%CI): 1.094 (0.558 - 2.147)).
CONCLUSIONAmong patients undergoing percutaneous coronary intervention for multivessel coronary artery disease, left ventricular dysfunction remains associated with further risk of cardiac death in-hospital and during long-term follow-up.