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Prognostic factors in patients with advanced multi-vessel coronary artery disease

Radosław Krecki1, Jarosław Drozdz, Maria Krzemińska-Pakuła

  • 1II Katedra i Klinika Kardiologii Uniwersytetu Medycznego, Wojewódzki Szpital Specjalistyczny im. W. Biegańskiego, ul. Kniaziewicza 1/5, 91-347 Łódź. rpmed1@wp.pl

Kardiologia Polska
|December 14, 2006
PubMed

Insights

In patients with multivessel coronary artery disease (CAD) ineligible for revascularization, low hemoglobin and high white blood cell count predict mortality. These factors are crucial for managing high-risk CAD patients.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Vascular Medicine

Background:

  • Multivessel coronary artery disease (CAD) poses a significant challenge, especially when revascularization is not an option.
  • Patients with this condition often have high mortality rates and are difficult to manage with medication alone.

Purpose of the Study:

  • To identify key unfavorable prognostic factors in patients with stable multivessel CAD.
  • Focus on patients unsuitable for percutaneous or surgical revascularization.

Main Methods:

  • Analysis of 106 patients with multivessel CAD disqualified from interventional treatment.
  • Data collected included age, comorbidities (diabetes, stroke), left ventricular ejection fraction, and Gensini score.
  • Follow-up period of 7.4 years.

Main Results:

  • Mortality was predicted by older age, higher heart rate, diabetes, renal failure, heart failure, past stroke, and lower ejection fraction.
  • Multivariate analysis revealed decreased hemoglobin and elevated leucocytosis as significant prognostic indicators.
  • Decreased hemoglobin (<12.3 g/dl) and increased leucocytosis (>11.3 t/mm3) were strongly associated with higher mortality (HR 6.3).

Conclusions:

  • Hemoglobin level and leucocytosis are critical prognostic factors in multivessel CAD patients not suitable for revascularization.
  • These factors may be as important as established risk factors.
  • Intensified pharmacotherapy and novel cell/gene therapies could improve outcomes for this patient group.
Abstract

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