Impact of left ventricular function in relation to procedural outcomes following percutaneous coronary intervention: insights from the British Cardiovascular Intervention Society.

Mamas A Mamas, Simon G Anderson, Peter D O'Kane, Bernard Keavney, James Nolan, Keith G Oldroyd, Divaka Perera, Simon Redwood, Azfar Zaman, Peter F Ludman, Mark A de Belder

    Research output: Contribution to journalArticlepeer-review

    Abstract

    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 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 LV function and mortality outcomes following PCI, with worsening LV function 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.
    Original languageEnglish
    JournalEuropean Heart Journal
    Volume35
    Issue number43
    DOIs
    Publication statusPublished - 14 Nov 2014

    Keywords

    • Left ventricular function
    • Outcomes
    • PCI

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