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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Percutaneous coronary intervention in patients with stable coronary artery disease and left ventricular systolic

Todd J Brophy1, Theodore J Warsavage2, Annika L Hebbe3

  • 1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH.

American Heart Journal
|February 10, 2021
PubMed

Insights

Percutaneous coronary intervention (PCI) significantly reduced mortality and rehospitalization in patients with ischemic cardiomyopathy and reduced left ventricular ejection fraction (LVEF ≤35%). This study highlights PCI as a beneficial treatment option for this patient group.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Heart Failure Research

Background:

  • Ischemic cardiomyopathy with reduced left ventricular ejection fraction (LVEF ≤35%) impacts patient survival.
  • Coronary artery bypass grafting improves survival, but percutaneous coronary intervention (PCI) role is less defined.

Purpose of the Study:

  • To evaluate the impact of PCI on mortality and hospitalization in patients with stable coronary artery disease and reduced LVEF.
  • To compare PCI outcomes against medical therapy in this specific patient population.

Main Methods:

  • Retrospective analysis of 4,628 patients within the Veterans Affairs Health Administration (2008-2015).
  • Included patients with angiographic evidence of stenoses amenable to PCI and LVEF ≤35%.
  • Propensity score weighted landmark analysis used to assess outcomes over a 3-year follow-up.

Main Results:

  • PCI was performed in 1,322 patients.
  • All-cause mortality was significantly lower in the PCI cohort (21.6%) versus medical therapy (30.0%, P <.001).
  • All-cause rehospitalization or death was also lower in the PCI cohort (76.5%) compared to medical therapy (83.8%, P <.001).

Conclusions:

  • PCI revascularization is associated with reduced all-cause mortality in patients with ischemic cardiomyopathy and LVEF ≤35%.
  • PCI treatment also decreased the combined outcome of all-cause death or rehospitalization in this cohort.
Abstract

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