Impact of depressed left ventricular function on outcomes in patients with three-vessel coronary disease undergoing percutaneous coronary intervention

作     者：GAO Zhan XU Bo Ajay J. Kirtane YANG Yue-jin YUAN Jin-qing CHEN Ji-lin QIAO Shu-bin WU Yong-jian QIN Xue-wen YAN Hong-bin YAO Min LIU Hai-bo CHEN Jue YOU Shi-jie GAO Run-lin 

作者机构：Cardiovascular Institute & Fu Wai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing100037 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2013年第126卷第4期

页      面：609-614页

核心收录：

学科分类：0710[理学-生物学] 071010[理学-生物化学与分子生物学] 1002[医学-临床医学] 07[理学] 0702[理学-物理学] 

主　　题：three-vessel coronary disease left ventricular dysfunction percutaneous coronary intervention 

摘      要：Background Patients with multivessel coronary artery disease and depressed left ventricular ejection fraction （LVEF） represent a high risk group of patients for coronary revascularization. There are limited data on percutaneous coronary intervention treatment in this population. Methods Among a cohort of 4335 patients with three-vessel disease with or without left main disease undergoing percutaneous coronary intervention, 191 patients had LVEF 〈40% （low ejection fraction （EF）） and 4144 patients had LVEF _〉40%. In-hospital and long-term outcomes were examined according to LVEF. Results The estimated two-year rates of major adverse cardiac events, cardiac death, and myocardial infarction were significantly higher in the low EF group （19.64% vs. 8.73%, Log-rank test： P 〈0.01; 10.30% vs. 1.33%, Log-rank test： P 〈0.01, and 10.32% vs. 2.28%, Log-rank test： P 〈0.01 respectively）, but there was no difference in the rates of target vessel revascularization （6.18% vs. 6.11%, Log-rank test： P=0.96）. Using the Cox proportional hazard models, LVEF 〈40% was a significant risk factor for cardiac death, myocardial infarction, and major adverse cardiac events （OR （95% CI）： 4.779 （2.369-9.637）, 2.673 （1.353-5.282）, and 1.827 （1.187-2.813） respectively）, but was not a statistically significant risk factor for target vessel revascularization （OR （95% CI）： 1.094 （0.558-2.147））. Conclusion Among patients undergoing percutaneous coronary intervention for multivessel coronary artery disease, left ventricular dysfunction remains associated with further risk of cardiac death in-hospital and during long-term follow-up.