Comparison of In-Hospital and One-Year outcomes in patients with left ventricular ejection fractions ≤40%, 41% to 49%, and ≥50% having percutaneous coronary revascularization

• Published in: The American journal of cardiology 2003-05, Vol.91 (10), p.1168-1172
• Main Authors: Keelan, Paul C, Johnston, Janet M, Koru-Sengul, Tulay, Detre, Katherine M, Williams, David O, Slater, James, Block, Peter C, Holmes, David R
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary - mortality; Biological and medical sciences; Confidence Intervals; Coronary Angiography; Coronary Disease - mortality; Coronary Disease - therapy; Diseases of the cardiovascular system; Endpoint Determination; Female; Follow-Up Studies; Hospital Mortality; Humans; Male; Medical sciences; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Regression Analysis; Stroke Volume - physiology; Survival Analysis; Survival Rate; Time Factors; Treatment Outcome; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(03)00261-3

Outcome studies of percutaneous coronary intervention (PCI) with conventional balloon angioplasty have established increased in-hospital and 1-year mortality in patients with left ventricular (LV) dysfunction compared with others. It is unclear whether recent PCI practice innovations, including stents and adjunctive pharmacotherapy, have made PCI safer and more effective in patients with LV dysfunction. We evaluated the influence of LV ejection fraction (EF) indexes on in-hospital and 1-year outcomes in 1,458 patients within the National Heart, Lung, and Blood Institute-sponsored Dynamic Registry. Patients (n = 300) with acute myocardial infarction were excluded. The remaining 1,158 patients were subdivided into 3 categories: group 1, EF ≤40% (n = 166); group 2, EF 41% to 49% (n = 126); and group 3, EF ≥50% (n = 866). We determined the frequency of individual and composite adverse events (death/myocardial infarction [MI]/coronary artery bypass grafting) at discharge and 1 year. In the Dynamic Registry patients, mean EF in the 3 groups was 32%, 45%, and 62% and in-hospital mortality was 3.0%, 1.6%, and 0.1%, respectively (p