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Factors associated with left ventricular reverse remodelling after percutaneous coronary intervention in patients

Yusuke Adachi1, Arihiro Kiyosue2, Jiro Ando1

  • 1Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Scientific Reports
|January 9, 2021
PubMed

Insights

Unprotected left main coronary artery intervention may improve left ventricular reverse remodelling in patients with coronary artery disease and reduced ejection fraction. Prior PCI and restenosis were associated with poorer outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Imaging

Background:

  • Percutaneous coronary intervention (PCI) is an alternative to surgical revascularization for coronary artery disease (CAD).
  • Predictors of left ventricular reverse remodelling (LVRR) after PCI in patients with reduced left ventricular ejection fraction (LVEF) are not well-defined.

Purpose of the Study:

  • To identify determinants of LVRR following PCI in patients with CAD and reduced LVEF.

Main Methods:

  • Analysis of 286 patients with LVEF < 50% who underwent PCI.
  • LVRR defined as LV end-systolic volume reduction ≥ 15% and LVEF improvement ≥ 10% at 6-month follow-up.
  • Multivariate logistic regression used to identify predictors of LVRR.

Main Results:

  • Unprotected left main coronary artery (LMCA) intervention was significantly associated with LVRR (OR 4.70).
  • Prior PCI (OR 0.35), in-stent restenosis (OR 0.32), and de-novo stenosis (OR 0.36) were negatively associated with LVRR.

Conclusions:

  • Unprotected LMCA intervention may offer prognostic benefits for LVRR in CAD patients with LV systolic dysfunction.
  • Regular angiographic follow-up is crucial for patients with CAD and LV systolic dysfunction.

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