Impact of Left Ventricular Ejection Fraction on Procedural and Long-Term Outcomes of Bifurcation Percutaneous Coronary Intervention.

Autor: Gallone G; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy., Kang J; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., Bruno F; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy., Han JK; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., De Filippo O; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy., Yang HM; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., Doronzo M; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy., Park KW; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., Mittone G; Department of Computer Science, University of Turin, Turin, Italy., Kang HJ; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., Parma R; Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland., Gwon HC; Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Cerrato E; Department of Cardiology, Infermi Hospital, Rivoli, Italy., Chun WJ; Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea., Smolka G; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy., Hur SH; Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea., Helft G; Pierre and Marie Curie University, Paris, France., Han SH; Division of Cardiology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea., Muscoli S; Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome, Italy., Song YB; Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Figini F; Pederzoli Hospital, Peschiera del Garda, Italy., Choi KH; Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Boccuzzi G; Department of Cardiology, S.G. Bosco Hospital, Torino, Italy., Hong SJ; Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea., Trabattoni D; Department of Cardiovascular Sciences, IRCCS Centro Cardiologico Monzino, Milan, Italy; University of Milan, Milan, Italy., Nam CW; Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea., Giammaria M; Division of Cardiology, Division of Cardiology, Ospedale Maria Vittoria, Turin, Italy., Kim HS; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., Conrotto F; Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Escaned J; Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain., Di Mario C; Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy., D'Ascenzo F; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy., Koo BK; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: bkkoo@snu.ac.kr., de Ferrari GM; Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2022 Jun 01; Vol. 172, pp. 18-25. Date of Electronic Publication: 2022 Mar 30.
DOI: 10.1016/j.amjcard.2022.02.015
Abstrakt: The association of left ventricular ejection fraction (LVEF) with procedural and long-term outcomes after state-of-the-art percutaneous coronary intervention (PCI) of bifurcation lesions remains unsettled. A total of 5,333 patients who underwent contemporary coronary bifurcation PCI were included in the intercontinental retrospective combined insights from the unified RAIN (veRy thin stents for patients with left mAIn or bifurcatioN in real life) and COBIS (COronary BIfurcation Stenting) III bifurcation registries. Of 5,003 patients (93.8%) with known baseline LVEF, 244 (4.9%) had LVEF <40% (bifurcation with reduced ejection fraction [BIFrEF] group), 430 (8.6%) had LVEF 40% to 49% (bifurcation with mildly reduced ejection fraction [BIFmEF] group) and 4,329 (86.5%) had ejection fraction (EF) ≥50% (bifurcation with preserved ejection fraction [BIFpEF] group). The primary end point was the Kaplan-Meier estimate of major adverse cardiac events (MACEs) (a composite of all-cause death, myocardial infarction, and target vessel revascularization). Patients with BIFrEF had a more complex clinical profile and coronary anatomy. No difference in procedural (30 days) MACE was observed across EF categories, also after adjustment for in-study outcome predictors (BIFrEF vs BIFmEF: adjusted hazard ratio [adj-HR] 1.39, 95% confidence interval [CI] 0.37 to 5.21, p = 0.626; BIFrEF vs BIFpEF: adj-HR 1.11, 95% CI 0.25 to 2.87, p = 0.883; BIFmEF vs BIFpEF: adj-HR 0.81, 95% CI 0.29 to 2.27, p = 0.683). BIFrEF was independently associated with long-term MACE (median follow-up 21 months, interquartile range 10 to 21 months) than both BIFmEF (adj-HR 2.20, 95% CI 1.41 to 3.41, p <0.001) and BIFpEF (adj-HR 1.91, 95% CI 1.41 to 2.60, p <0.001) groups, although no difference was observed between BIFmEF and BIFpEF groups (adj-HR 0.87, 95% CI 0.61 to 1.24, p = 0.449). In conclusion, in patients who underwent PCI of a coronary bifurcation lesion according to contemporary clinical practice, reduced LVEF (<40%), although a strong predictor of long-term MACEs, does not affect procedural outcomes.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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