Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis
Background The association between left ventricular ejection fraction (LVEF) change (ΔLVEF) following percutaneous coronary intervention (PCI) and the long‐term mortality rate in patients with coronary artery disease is incompletely investigated. We aimed to assess the impact of PCI on LVEF and the...
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Wiley
2024-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.035791 |
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| author | Gjin Ndrepepa Salvatore Cassese Robert A. Byrne Blerina Bevapi Michael Joner Hendrik B. Sager Sebastian Kufner Erion Xhepa Tareq Ibrahim Karl‐Ludwig Laugwitz Heribert Schunkert Adnan Kastrati |
| author_facet | Gjin Ndrepepa Salvatore Cassese Robert A. Byrne Blerina Bevapi Michael Joner Hendrik B. Sager Sebastian Kufner Erion Xhepa Tareq Ibrahim Karl‐Ludwig Laugwitz Heribert Schunkert Adnan Kastrati |
| author_sort | Gjin Ndrepepa |
| collection | DOAJ |
| description | Background The association between left ventricular ejection fraction (LVEF) change (ΔLVEF) following percutaneous coronary intervention (PCI) and the long‐term mortality rate in patients with coronary artery disease is incompletely investigated. We aimed to assess the impact of PCI on LVEF and the association of ΔLVEF after PCI with the long‐term mortality rate. Methods and Results This observational study included 8181 patients with paired angiographic LVEF measurements performed at baseline and 6 to 8 months following the index PCI. ΔLVEF was defined as LVEF measured on the 6‐ to 8‐month angiography minus LVEF measured on the baseline angiography. LVEF change was classified according to the following categories: reduced (ΔLVEF <0), mildly improved (ΔLVEF >0% to <10%) and largely improved (ΔLVEF ≥10%). The primary outcome was the 5‐year mortality rate. In patients with baseline LVEF <40%, 40% to <50% and ≥50%, ΔLVEF (median [25th–75th percentiles]) was 6.0% [0.0% to 14.0%], 4.0% [−1.0% to 11.0%] and 0.0% [−4.0% to 3.0%], respectively (P<0.001). In patients with reduced, mildly improved, and largely improved ΔLVEF, the 5‐year mortality rate (n=712) was 29.1%, 23.1%, and 16.5%, respectively, in patients with baseline LVEF <40%; 17.0%, 12.2% and 9.8%, respectively, in patients with baseline LVEF 40% to <50%; and 7.8%, 7.1%, and 5.6%, respectively, in patients with baseline LVEF ≥50% (adjusted hazard ratio [HR], 0.91 [95% CI, 0.86–0.96]; P<0.001) for all‐cause death and adjusted (HR, 0.86 [95% CI, 0.81–0.92]; P<0.001) for cardiac death, calculated for 5% higher ΔLVEF. Conclusions In patients with coronary artery disease undergoing PCI, improvement of LVEF following PCI was associated with a reduced long‐term mortality rate in patients with reduced LVEF but not in patients with preserved LVEF before intervention. |
| format | Article |
| id | doaj-art-acc1735c326f4f7ebc085eb0ad265059 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-acc1735c326f4f7ebc085eb0ad2650592024-11-29T09:50:50ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-11-01132110.1161/JAHA.124.035791Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With PrognosisGjin Ndrepepa0Salvatore Cassese1Robert A. Byrne2Blerina Bevapi3Michael Joner4Hendrik B. Sager5Sebastian Kufner6Erion Xhepa7Tareq Ibrahim8Karl‐Ludwig Laugwitz9Heribert Schunkert10Adnan Kastrati11Department of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology and Cardiovascular Research Institute (CVRI) Mater Private Network Dublin IrelandDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyMedizinische Klinik und Poliklinik Innere Medizin I (Kardiologie, Angiologie, Pneumologie), Klinikum rechts der Isar Technische Universität München Munich GermanyGerman Center for Cardiovascular Research (DZHK) Partner Site Munich Heart Alliance Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyDepartment of Cardiology, Deutsches Herzzentrum München Technische Universität München Munich GermanyBackground The association between left ventricular ejection fraction (LVEF) change (ΔLVEF) following percutaneous coronary intervention (PCI) and the long‐term mortality rate in patients with coronary artery disease is incompletely investigated. We aimed to assess the impact of PCI on LVEF and the association of ΔLVEF after PCI with the long‐term mortality rate. Methods and Results This observational study included 8181 patients with paired angiographic LVEF measurements performed at baseline and 6 to 8 months following the index PCI. ΔLVEF was defined as LVEF measured on the 6‐ to 8‐month angiography minus LVEF measured on the baseline angiography. LVEF change was classified according to the following categories: reduced (ΔLVEF <0), mildly improved (ΔLVEF >0% to <10%) and largely improved (ΔLVEF ≥10%). The primary outcome was the 5‐year mortality rate. In patients with baseline LVEF <40%, 40% to <50% and ≥50%, ΔLVEF (median [25th–75th percentiles]) was 6.0% [0.0% to 14.0%], 4.0% [−1.0% to 11.0%] and 0.0% [−4.0% to 3.0%], respectively (P<0.001). In patients with reduced, mildly improved, and largely improved ΔLVEF, the 5‐year mortality rate (n=712) was 29.1%, 23.1%, and 16.5%, respectively, in patients with baseline LVEF <40%; 17.0%, 12.2% and 9.8%, respectively, in patients with baseline LVEF 40% to <50%; and 7.8%, 7.1%, and 5.6%, respectively, in patients with baseline LVEF ≥50% (adjusted hazard ratio [HR], 0.91 [95% CI, 0.86–0.96]; P<0.001) for all‐cause death and adjusted (HR, 0.86 [95% CI, 0.81–0.92]; P<0.001) for cardiac death, calculated for 5% higher ΔLVEF. Conclusions In patients with coronary artery disease undergoing PCI, improvement of LVEF following PCI was associated with a reduced long‐term mortality rate in patients with reduced LVEF but not in patients with preserved LVEF before intervention.https://www.ahajournals.org/doi/10.1161/JAHA.124.035791coronary artery diseaseleft ventricular ejection fractiondeathpercutaneous coronary intervention |
| spellingShingle | Gjin Ndrepepa Salvatore Cassese Robert A. Byrne Blerina Bevapi Michael Joner Hendrik B. Sager Sebastian Kufner Erion Xhepa Tareq Ibrahim Karl‐Ludwig Laugwitz Heribert Schunkert Adnan Kastrati Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary artery disease left ventricular ejection fraction death percutaneous coronary intervention |
| title | Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis |
| title_full | Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis |
| title_fullStr | Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis |
| title_full_unstemmed | Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis |
| title_short | Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis |
| title_sort | left ventricular ejection fraction change following percutaneous coronary intervention correlates and association with prognosis |
| topic | coronary artery disease left ventricular ejection fraction death percutaneous coronary intervention |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.035791 |
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