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Lookup NU author(s): Professor Bernard Keavney, Professor Azfar Zaman, Dr Mark De Belder
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Aim Between 10 and 30% of patients undergoing percutaneous coronary intervention (PCI) have left ventricular (LV) dysfunction. We investigate the association between LV function on early and late mortality outcomes in a national 'real-world' cohort undergoing PCI in the elective and acute coronary syndrome setting through analysis of the British Cardiovascular Intervention Society (BCIS) data set.Methods and results The relationship between LV function and 30-day mortality in patients undergoing PCI for elective, ST-elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) indications was studied in 230 464 patients in the UK between 2006 and 2011. Abnormal LV function was an independent predictor of 30-day mortality outcomes: 30-day mortality risk for patients with moderate LV function (EF: 30-49%) (HR: 2.91; 95% CI: 2.43-3.49, P < 0.0001) and poor LV function (EF, 30%) (HR: 7.25; 95% CI: 5.87-8.96, P < 0.0001) was compared with patients with good LV function (EF. 50%). The independent prognostic impact of poor LV function on 30-day mortality increased from elective PCI (HR: 3.72: 95% CI: 2.21-6.25, P < 0.0001) through to the NSTEMI (HR: 5.03: 95% CI: 3.64-6.93, P < 0.0001) and STEMI (HR: 8.18: 95% CI: 5.62-11.92, P < 0.0001).Conclusions Our data suggest a strong relationship between LVfunction and mortality outcomes following PCI, with worsening LVfunction independently predicting 30-day and longer-term mortality outcomes across all indications for PCI. We report a differential impact of LV function on mortality outcomes across different indications for PCI, with the greatest adverse prognostic association between worsening LV function and mortality outcomes observed in patients undergoing PCI in the STEMI setting.
Author(s): Mamas MA, Anderson SG, O'Kane PD, Keavney B, Nolan J, Oldroyd KG, Perera D, Redwood S, Zaman A, Ludman PF, de Belder MA, British Cardiovasc Intervention, Natl Inst Cardiovasc Outcomes Res
Publication type: Article
Publication status: Published
Journal: European Heart Journal
Year: 2014
Volume: 35
Issue: 43
Pages: 3004-3012
Print publication date: 14/11/2014
Online publication date: 28/08/2014
Acceptance date: 16/07/2014
ISSN (print): 0195-668X
ISSN (electronic): 1522-9645
Publisher: Oxford University Press
URL: http://dx.doi.org/10.1093/eurheartj/ehu303
DOI: 10.1093/eurheartj/ehu303
PubMed id: 25168601
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