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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

Safety of drug-eluting stents in patients with left ventricular dysfunction undergoing percutaneous coronary

Annunziata Nusca1, Michael J Lipinski, Amit Varma

  • 1VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA. aabbate@mcvh-vcu.edu

The American Journal of Cardiology
|September 9, 2008
PubMed

Insights

Drug-eluting stents (DES) are safe for patients with reduced left ventricular (LV) ejection fraction (EF). This study found favorable long-term survival rates in patients with LV dysfunction receiving DES, suggesting their safety in this high-risk group.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Research

Background:

  • Drug-eluting stents (DES) are associated with increased late stent thrombosis.
  • Reduced left ventricular ejection fraction (LVEF) is a known risk factor for stent thrombosis.
  • The safety of DES in patients with impaired left ventricular function requires further investigation.

Purpose of the Study:

  • To evaluate the long-term safety and efficacy of DES implantation in patients with left ventricular (LV) dysfunction.
  • To assess the incidence of all-cause mortality in patients with LVEF <45% treated with DES.
  • To compare outcomes of DES versus bare-metal stents (BMS) in patients with LV dysfunction.

Main Methods:

  • Retrospective analysis of patients with LVEF <45% who received at least one DES.
  • Data collection on all-cause mortality using Social Security Database and hospital records.
  • Comparison with a historical cohort of patients with LV dysfunction treated with BMS.

Main Results:

  • 121 patients with mean LVEF of 36±8% received DES; 16% had LVEF ≤25%.
  • 3-year survival rates were 88% (95% CI 80-96%), demonstrating favorable outcomes.
  • DES implantation was off-label in 83% of patients, highlighting use in a high-risk population.

Conclusions:

  • Drug-eluting stents (DES) demonstrate a favorable safety profile in patients with left ventricular (LV) dysfunction.
  • Long-term survival rates are encouraging, supporting the use of DES in this patient cohort.
  • Further research may explore optimal DES selection and management strategies for patients with LV dysfunction.

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