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Independent and cumulative association of clinical and morphological heart failure with long-term outcome after percutaneous coronary intervention.

Abstract：

BACKGROUND:Heart failure (HF) is a risk factor for adverse post-procedural outcome after revascularization; however, it is unclear how left ventricular systolic dysfunction (LVSD) and clinical HF symptoms affect percutaneous coronary intervention (PCI) outcomes. We investigated the characteristics and long-term outcomes of patients with clinical HF or LVSD after PCI. METHODS:This was a Japanese multicenter registry study of adult patients receiving PCI. Among 4689 consecutive patients who underwent PCI at 15 hospitals from January 2009 to December 2012, we analyzed 2634 (56.2%) with documented left ventricular ejection fraction (LVEF). They were divided into four groups based on clinical HF (symptoms or HF hospitalization) and LVEF [≥35% and <35% (HF due to LVSD)]. The primary outcome was major adverse cardiovascular events (MACE), comprising all-cause death, acute coronary syndrome, HF hospitalization, performance of coronary artery bypass grafting, and stroke within 2 years after the initial PCI. RESULTS:Our findings revealed 354 patients (13.4%) with HF (clinical HF, n = 173, 48.9%; LVSD, n = 132, 37.3%; both, n = 49; 13.8%). The incidence of MACE was higher in patients with clinical HF or LVSD, and was largely due to higher non-cardiac death and HF hospitalization. After adjustment, clinical HF (hazard ratio 2.16, 95% confidence interval; 1.49-3.14) and lower LVEF (per 10%, hazard ratio 0.89, 95% confidence interval; 0.81-0.99) were independently associated with higher MACE risk. CONCLUSIONS:Clinical HF and LVSD were independently associated with adverse long-term clinical outcomes, particularly with non-cardiac death and HF readmission, in patients treated with PCI.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Kimura M,Kohno T,Sawano M,Heidenreich PA,Ueda I,Takahashi T,Matsubara T,Ueno K,Hayashida K,Yuasa S,Ohki T,Fukuda K,Kohsaka S

doi

10.1016/j.jjcc.2020.06.014

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

41-47

issue

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(20)30208-2

journal_volume

pub_type

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Independent and cumulative association of clinical and morphological heart failure with long-term outcome after percutaneous coronary intervention.