Appraising the impact of left ventricular ejection fraction on outcomes of percutaneous drug-eluting stenting for unprotected left main disease: insights from a multicenter registry of 975 patients
| Autor: | Giovanni Falsini, Luigi Vignali, Antonio Marzocchi, Massimo Margheri, Imad Sheiban, Giuseppe Sangiorgi, Giuseppe Biondi-Zoccai, Andrea Santarelli, Stefano De Servi, Corrado Tamburino, Vincenzo Filippone, Diego Sangiorgi, Carlo Briguori, Angelo Ramondo, Claudio Moretti, Fabio Barlocco, Giuseppe Vecchi, Francesco Di Pede, Cataldo Palmieri, Marco De Carlo, Massimo Medda, Alberto Benassi, Antonio L. Bartorelli, Tullio Palmerini, Davide Capodanno |
|---|---|
| Přispěvatelé: | Biondi-Zoccai G, Sheiban I, Moretti C, Palmerini T, Marzocchi A, Capodanno D, Tamburino C, Margheri M, Vecchi G, Sangiorgi G, Santarelli A, Bartorelli AL, Briguori C, Vignali L, Pede F, Ramondo A, Medda M, De Carlo M, Falsini G, Benassi A, Palmieri C, Filippone V, Sangiorgi D, Barlocco, De Servi S. |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
Percutaneous Time Factors medicine.medical_treatment Myocardial Infarction Coronary Artery Disease Ventricular Function Left Coronary artery disease Ventricular Dysfunction Left Risk Factors Cause of Death Odds Ratio Registries Angioplasty Balloon Coronary media_common Aged 80 and over Left ventricular dysfunction Ejection fraction Drug-Eluting Stents General Medicine STENTS Middle Aged surgical procedures operative Treatment Outcome Italy Cardiology cardiovascular system Female Cardiology and Cardiovascular Medicine therapeutics Drug medicine.medical_specialty media_common.quotation_subject education Heart failure Prosthesis Design Risk Assessment Internal medicine medicine Humans cardiovascular diseases coronary artery disease heart failure left ventricular dysfunction percutaneous transluminal coronary angioplasty stent Percutaneous transluminal coronary angioplasty Aged Retrospective Studies Chi-Square Distribution business.industry Patient Selection Stent Percutaneous coronary intervention Stroke Volume medicine.disease Logistic Models Conventional PCI business |
| Popis: | Background: Despite the well-known prognostic impact of systolic dysfunction in unselected patients undergoing percutaneous coronary intervention (PCI), limited data are available on its current predictive role after PCI for unprotected left main disease (ULM). We thus appraised the prognostic role of left ventricular ejection fraction (LVEF) in patients undergoing PCI for ULM with drug-eluting stents (DES). Methods: Consecutive eligible subjects were retrospectively enrolled in a national registry. Patients were divided into three groups: LVEF < 30%, LVEF 30-45%, and LVEF > 45%. Relevant baseline and outcome data were compared with bivariate and multivariable tests. Results: A total of 975 subjects was included (LVEF < 30%: 46, LVEF 30-45%: 208, LVEF > 45%: 721). Patients with LVEF < 30% had several other unfavorable clinical features, including older age and higher EuroSCORE. Adverse event rates were different already at 7 days (p = 0.012 for all-cause death and p = 0.015 for major adverse cardiac events [MACE]), with even more significant trends up to 30 days and at long-term (p < 0.001 for death, and p < 0.001 for MACE). After a median of 18 months, risk of death totaled 39 versus 13 versus 8% (p < 0.001) and risk of MACE 44 versus 24 versus 22% (p = 0.003). Multivariable analyses showed however that reduced LVEF was not an independent predictor of adverse events at any time-point. Conclusions: Whereas reduced LVEF is apparently a significant predictor of adverse events after PCI with DES for ULM, its prognostic impact is mostly due to clustering with other adverse feature |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|