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Reduced Left Ventricular Ejection Fraction Is a Risk Factor for In-Hospital Mortality in Patients after Percutaneous
Ziliang Ye1, Haili Lu2, Lang Li1
1Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Insights
Reduced left ventricular ejection fraction (LVEF) increases in-hospital mortality risk in patients undergoing percutaneous coronary intervention (PCI). This study found lower mortality in patients with preserved ejection fraction post-PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes
Background:
- Assessing the prognostic value of reduced left ventricular ejection fraction (LVEF) in patients following percutaneous coronary intervention (PCI).
- Understanding risk factors for adverse events after PCI is crucial for patient management.
Purpose of the Study:
- To determine if a reduced LVEF is an independent risk factor for adverse outcomes after PCI.
- To compare in-hospital mortality, revascularization rates, and myocardial infarction (MI) in patients with and without reduced LVEF post-PCI.
Main Methods:
- Retrospective cohort study including 1600 patients who underwent PCI between February 2013 and January 2017.
- Patients were stratified into two groups: reduced LVEF (<50%) and preserved LVEF (≥50%).
- Evaluation of in-hospital mortality, revascularization, and MI rates.
Main Results:
- Patients with reduced LVEF (<50%) had significantly higher in-hospital mortality (3.68%) compared to those with preserved LVEF (≥50%) (0.12%) (P<0.001).
- No significant differences were observed in revascularization or in-hospital MI rates between the groups.
- Multivariate analysis confirmed that reduced LVEF was associated with increased in-hospital mortality (OR: 1.15, 95% CI: 1.08 to 1.33).
Conclusions:
- Reduced left ventricular ejection fraction (LVEF) is a significant risk factor for in-hospital mortality in patients undergoing percutaneous coronary intervention (PCI).
- Preserved LVEF is associated with better in-hospital survival after PCI.
- LVEF status does not appear to influence the need for revascularization or the incidence of in-hospital MI post-PCI.
Background:
To evaluate whether a reduced left ventricular ejection fraction (LVEF) is a risk factor in patients after percutaneous coronary intervention (PCI).
Methods:
A retrospective cohort study from February 2013 to January 2017 was performed, and 1600 patients were included (136 patients with EF <50% and 1464 patients with EF ≥50%); all patients underwent PCI. Revascularization, in-hospital mortality, and in-hospital myocardial infarction (MI) during hospitalization were evaluated.
Results:
The mean age of patients with EF <50% was 62.18 ± 10.31 years, while the mean age of patients with EF ≥50% was 60.06 ± 10.89 years (P=0.029). In-hospital mortality of patients with EF ≥50% was significantly lower than that of patients with EF <50% (0.12% vs. 3.68%, P<0.001), while no difference was observed in revascularization and in-hospital MI between the two groups (2.39% vs. 2.20%, P=0.892; 0.415% vs. 1.47%, P=0.093, respectively). In the univariate analysis, no significant difference was found in revascularization and in-hospital MI between the two groups (OR: 1.50, 95% CI: 0.95 to 2.38; OR: 0.28, 95% CI: 0.06 to 1.38, respectively) except for in-hospital mortality (OR: 1.12, 95% CI: 1.05 to 1.27). In multivariate analyses, in-hospital mortality of patients with EF ≥50% was still significantly lower than of patients with EF <50% (OR: 1.15, 95% CI: 1.08 to 1.33). There were no differences in revascularization and in-hospital MI between the two groups (OR: 0.85, 95% CI: 0.44 to 1.63; OR: 0.04, 95% CI: 0.00 to 1.84, respectively).
Conclusions:
Reduced LVEF is a risk factor for in-hospital mortality in patients after PCI.
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