Percutaneous coronary intervention of chronic total occlusions in patients with low left ventricular ejection fraction
Autor: | Aurel Toma, Marouane Boukhris, Franz J. Neumann, Oliver Gaemperli, Thomas F. Lüscher, Alfredo R. Galassi, Michael Behnes, Lobna Laroussi, Kambis Mashayekhi, Zied Ibn Elhadj, Ibrahim Akin |
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Přispěvatelé: | University of Zurich, Galassi, Alfredo R, Galassi, Alfredo R., Boukhris, Marouane, Toma, Aurel, Elhadj, Zied Ibn, Laroussi, Lobna, Gaemperli, Oliver, Behnes, Michael, Akin, Ibrahim, Lüscher, Thomas F., Neumann, Franz J., Mashayekhi, Kambis |
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty animal structures Time Factors medicine.medical_treatment 610 Medicine & health Kaplan-Meier Estimate 030204 cardiovascular system & hematology Coronary Angiography Disease-Free Survival Ventricular Function Left 2705 Cardiology and Cardiovascular Medicine chronic total occlusion ischemic LV dysfunction left ventricular ejection fraction PCI Cardiology and Cardiovascular Medicine chronic total occlusionischemic LV dysfunctionleft ventricular ejection fractionPCI 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Risk Factors Internal medicine medicine Humans In patient cardiovascular diseases 030212 general & internal medicine Longitudinal Studies Prospective Studies Aged Proportional Hazards Models Ejection fraction business.industry Percutaneous coronary intervention Stroke Volume Recovery of Function Middle Aged Surgery Europe Treatment Outcome Coronary Occlusion Conventional PCI Chronic Disease Cardiology 10209 Clinic for Cardiology Female business |
Popis: | Objectives The study sought to assess the outcome of percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) in patients with low left ventricular ejection fraction (LVEF) (≤35%). Background Data regarding the outcome of PCI in patients with low LVEF affected by CTO are scarcely reported. Methods The authors performed a prospective longitudinal multicenter study including consecutive patients undergoing elective PCI of CTOs. Patients were subdivided into 3 groups: group 1 (LVEF ≥50%), group 2 (LVEF 35% to 50%), and group 3 (LVEF ≤35%). Results A total of 839 patients (mean 64.6 ± 10.5 years of age, 87.7% men) underwent CTO PCI attempts. Baseline LVEF ≤35% was present in 72 (8.6%) patients. The angiographic success was high (overall 93.6%) and similar among the 3 groups (93.5% vs. 94.4% vs. 91.7%, respectively; all p = NS). In group 3, no periprocedural complications of CTO PCI were observed. Mean clinical follow-up of 16.3 ± 8.2 months duration was available in 781 (93.1%) patients including those with LVEF ≤35%. At 2 years, major cardiac and cerebrovascular events (MACCE) free survival was similar in the 3 groups (86% vs. 82.8% vs. 75.2%; all p = NS). In patients with LVEF ≤35%, LVEF improved significantly in the presence of a successful CTO PCI from 29.1 ± 3.4% to 41.6 ± 7.9% (p < 0.001). Conclusions In CTO patients with low LVEF, PCI could represent a safe and effective revascularization strategy achieving good midterm outcome and LVEF improvement. |
Databáze: | OpenAIRE |
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