1.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.
Gwan Hyeop SOHN ; Jeong Hoon YANG ; Seung Hyuk CHOI ; Young Bin SONG ; Joo Yong HAHN ; Jin Ho CHOI ; Hyeon Cheol GWON ; Sang Hoon LEE
Journal of Korean Medical Science 2014;29(11):1501-1506
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.
Age Factors
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Aged
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Coronary Artery Disease/*drug therapy/mortality/physiopathology
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Diabetes Mellitus, Type 2/complications
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*Drug-Eluting Stents
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Female
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Follow-Up Studies
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Humans
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Kaplan-Meier Estimate
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Male
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Middle Aged
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Myocardial Infarction/etiology
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Myocardial Revascularization
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Percutaneous Coronary Intervention/adverse effects
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Proportional Hazards Models
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Renal Insufficiency, Chronic/complications
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Retrospective Studies
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Sex Factors
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Treatment Outcome
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Ventricular Dysfunction, Left/physiopathology