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Recovery of Left Ventricular Function After Percutaneous Coronary Intervention Compared to Coronary Artery Bypass

Noa P Yee1, Andrea M Siu1, James Davis1

  • 1Undergraduate, Tufts University, Medford, MA.

Hawai'I Journal of Medicine & Public Health : a Journal of Asia Pacific Medicine & Public Health
|October 1, 2016
PubMed

Insights

Coronary artery bypass grafting (CABG) showed greater left ventricular (LV) function recovery than percutaneous coronary intervention (PCI) in patients with severely reduced LV ejection fraction (LVEF) and multivessel coronary artery disease (CAD). CABG may be preferred.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Left ventricular (LV) function recovery after revascularization is documented for coronary artery bypass grafting (CABG).
  • LV function recovery following percutaneous coronary intervention (PCI) and its comparison to CABG is less understood.
  • Severely reduced LV function in multivessel coronary artery disease (CAD) presents a critical clinical scenario.

Purpose of the Study:

  • To compare LV function recovery between PCI and CABG in patients with severely reduced LV ejection fraction (LVEF) and multivessel CAD.
  • To evaluate the long-term efficacy of PCI versus CABG in improving LVEF in this patient cohort.

Main Methods:

  • Single-center retrospective study including 192 patients (16 CABG, 176 PCI) with LVEF < 40% and multivessel CAD.
  • Analysis of LVEF at baseline, 6 months, and 12 months post-revascularization.
  • Statistical comparison of LVEF changes between the PCI and CABG groups.

Main Results:

  • Baseline LVEF differed significantly between groups (PCI: 28.5 ± 8.0 vs. CABG: 24.2 ± 6.8, P=.05).
  • No significant difference in LVEF recovery was observed at 6 months.
  • At 12 months, CABG demonstrated significantly greater LVEF recovery (15.25) compared to PCI (4.82) (P=.005).

Conclusions:

  • Both PCI and CABG lead to statistically significant LVEF improvement over time in patients with severely reduced LV function and multivessel CAD.
  • Coronary artery bypass grafting (CABG) is associated with superior LVEF recovery compared to percutaneous coronary intervention (PCI) at one-year follow-up.
  • CABG may be the preferred revascularization strategy for patients with depressed LV function and multivessel coronary artery disease.

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