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Outcomes After PCI in Patients with LV Dysfunction
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.
Background: Coronary artery disease (CAD) is the most common cause of left ventricular dysfunction. Percutaneous coronary intervention (PCI) in patient with LV dysfunction is a high risk procedure and may be associated with adverse outcomes. We observed for outcomes after PCI in the elective and acute coronary syndrome setting in patient with LV dysfunction.
Methods: A prospective single center study was performed in 836 patients with and without LV dysfunction who underwent PCI with a follow up period of 1 year for MACCE.
Results: A total of 836 patients were studied. 329 (39.4%) patients have LV dysfunction (LVD) and 507 (60.6%) patients have good LV function (GLV). Among the patients with LVD, 160 (48.6%) has mild, 89 (27.1%) has moderate, 80 (24.3%) has severe LVD. Mean age was 56.5±12.5 years in patients with GLV and 58.8±10 years in LVD patients (p=0.003). Number of males were 259 (78.7%) in LVD and 364 (71.7%) in GLV group. Hypertension and diabetes were present in 237(72%) vs 368(72.5%), 168 (51%) vs 286 (56.4%) in LVD and GLV groups respectively (p=0.8, 0.1). There was no difference in the previous history of CABG (5.2% vs 3.4%, p=0.2) and PCI (19.5% vs 16.4%, p=0.3) in both groups. 174 (52.9%) patients with LVD and 409 (80.7%) patients with GLV has chronic stable angina. Multivessel PCI was done in 79 (24%) patients with LVD and 110 (21.7%) patients with GLV (p=0.4). Major adverse cardiovascular and cerebrovascular events (MACCE) occurred in 3 patients with mild, 5 patients with moderate, 6 patients with severe LVD during the follow up of 1 year. There was no difference in outcomes between the LVD and GLV group at one year (p=0.2), but when a subgroup analysis was made among patients with LV dysfunction there was a significant occurrence of MACCE in patients with severe LV dysfunction when compared with mild LVD (p=0.05).
Conclusion: There was no significant difference between the occurrence of MACCE in patients with LV dysfunction and without LV dysfunction who underwent PCI. But when a subgroup analysis was done there was a significant occurrence of MACCE in patients with severe LV dysfunction (p=0.05) when compared to mild LVD.