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Clinical and angiographic correlates of left ventricular dysfunction in patients with three vessel coronary disease.

Abstract：

BACKGROUND:Among patients with advanced multivessel coronary disease, left ventricular (LV) function is widely variable, and clinical and angiographic correlates of ventricular dysfunction remain to be defined. METHODS:Among 73 339 patients undergoing diagnostic cardiac catheterization at a single center in China, patients with left ventriculographic assessment were identified with three-vessel coronary disease with or without left main involvement. Clinical and angiographic characteristics were examined among patients with normal or varying extent of LV dysfunction, and predictors of LV impairment (ejection fraction (EF): < 25%, 25% - 40% or > 40%) were determined. RESULTS:Among 11 950 patients identified with three-vessel coronary disease, the sample distribution of LVEF was > 40%, n = 10 776; 25% - 40%, n = 948; < 25%, n = 226. Patients with reduced LV function (< 40%) more commonly were male and had a history of myocardial infarction (MI), diabetes or unstable angina. Hypertension was more frequent in those with LVEF ≥ 40%. In a multivariate Logistic regression analysis, prior MI (odds ratio (OR), 3.37; 95% confidence interval (CI), 2.96 - 3.84) was most predictive of LVEF < 40%, followed by male gender, diabetes, and presentation with unstable angina. For LVEF < 25%, only prior MI was identified as a significant correlate of severe LV dysfunction (OR 4.06, 95%CI 3.06 - 5.39). Following exclusion of patients with previous MI (n = 7416), male gender and diabetes were predictive of LVEF < 40%, yet presentation with unstable angina was the only factor significantly associated with LVEF < 25%. CONCLUSION:Among individuals identified with three-vessel coronary disease with or without left main involvement, previous MI was the most significant risk factor of LV dysfunction.

journal_name

Chin Med J (Engl)

journal_title

Chinese medical journal

authors

Gao Z,Xu B,Yang YJ,Kandzari DE,Yuan JQ,Chen J,Chen JL,Qiao SB,Wu YJ,Yan HB,Qin XW,Yao M,Liu HB,Dai J,Chen T,Teng SY,Gao RL

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

4221-5

issue

eissn

0366-6999

issn

2542-5641

journal_volume

125

pub_type

杂志文章

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Clinical and angiographic correlates of left ventricular dysfunction in patients with three vessel coronary disease.