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Complete percutaneous revascularisation feasibility in ischaemic heart failure is related to improved outcomes:

Łukasz Pyka1, Michał Hawranek, Mateusz Tajstra

  • 1wookash.p@gmail.com.

Kardiologia Polska
|February 3, 2017
PubMed

Insights

Complete revascularization with percutaneous coronary intervention (PCI) significantly lowers 12-month mortality in systolic heart failure (HF) patients with multi-vessel coronary artery disease. This approach offers improved survival outcomes for ischaemic HF.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Heart Failure Research

Background:

  • Heart failure (HF) is a leading cause of cardiovascular death.
  • Data on percutaneous coronary intervention (PCI) in systolic HF is limited post-STICH.
  • Complete revascularization in ischaemic HF remains an unresolved clinical question.

Purpose of the Study:

  • To evaluate the impact of complete versus incomplete revascularization using PCI on mortality in systolic HF patients.
  • To assess the safety and feasibility of PCI for revascularization in ischaemic HF.

Main Methods:

  • The COMMIT-HF registry enrolled 1798 systolic HF patients (LVEF ≤ 35%).
  • A subgroup with multi-vessel coronary artery disease undergoing PCI was analyzed (complete n=188, incomplete n=159).
  • Completeness defined as successful PCI of all significant lesions; primary endpoint was 12-month all-cause mortality.

Main Results:

  • Complete revascularization was associated with significantly lower 12-month all-cause mortality (6.4% vs. 20.1%, p < 0.001).
  • Multivariate analysis identified complete revascularization as an independent predictor of improved survival (HR 0.39).
  • No significant differences in procedural characteristics or complication rates were observed between groups.

Conclusions:

  • Percutaneous coronary intervention is a safe and feasible revascularization strategy for ischaemic heart failure.
  • Achieving complete revascularization via PCI is linked to better clinical outcomes in this patient population.
Abstract

Keywords:
coronary artery diseaseheart failurepercutaneous coronary intervention

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