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

被引:60
作者
Keelan, PC
Johnston, JM
Koru-sengul, T
Detre, KM
Williams, DO
Slater, J
Block, PC
Holmes, DR
机构
[1] Mayo Clin & Mayo Fdn, Div Cardiovasc Dis, Rochester, MN 55905 USA
[2] Univ Pittsburgh, Pittsburgh, PA USA
[3] Rhode Isl Hosp, Providence, RI USA
[4] St Lukes Roosevelt Hosp, New York, NY USA
[5] Providence St Vincent Med Ctr, Portland, OR USA
关键词
ANGIOPLASTY; SURVIVAL; MORTALITY; SURGERY;
D O I
10.1016/S0002-9149(03)00261-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 less than or equal to40% [n = 166); group 2, EF 41% to 49% (n = 126); and group 3, EF greater than or equal to50% (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 <0.001). The composite end point of death/MI was also significant, but other in-hospital adverse events did not differ between groups. The respective mortality rates were 11.0%, 4.5%, and 1.9% (p <0.001) after I year. The composite end points of death/MI and death/MI/coronary artery bypass grafting also occurred more frequently in group 1 patients. Thus, significant LV dysfunction was still associated with increased in-hospital and 1-year mortality in patients having contemporary PCI. (C) 2003 by Excerpta Medica, Inc.
引用
收藏
页码:1168 / 1172
页数:5
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