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Updated: Sep 17, 2025
An Intact Pericardium Ischemic Rodent Model
Published on: September 2, 2021
Clinical Phenotypes of Patients With Ischemic Cardiomyopathy After Percutaneous Coronary Intervention
Daisuke Nakamura1, Isamu Mizote1, Tomoharu Dohi1
1Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine.
Insights
Latent class analysis identified three distinct phenotypes of ischemic cardiomyopathy (ICM) in patients undergoing percutaneous coronary intervention (PCI). Phenotype 2 showed significantly lower mortality and heart failure hospitalization risks, suggesting tailored treatments for ICM subtypes.
Area of Science:
- Cardiology
- Medical Informatics
- Clinical Research
Background:
- Percutaneous coronary intervention (PCI) is a treatment option for patients with ischemic cardiomyopathy (ICM) at high risk for surgery.
- The effectiveness of PCI in ICM is debated, possibly due to the condition's heterogeneity.
- Latent class analysis (LCA) can identify distinct patient subgroups based on clinical features.
Purpose of the Study:
- To characterize ischemic cardiomyopathy (ICM) phenotypes using latent class analysis (LCA).
- To assess clinical outcomes, including mortality and heart failure hospitalization, across identified ICM phenotypes after percutaneous coronary intervention (PCI).
- To explore the role of left ventricular reverse remodeling (LVRR) in different ICM phenotypes.
Main Methods:
- Latent class analysis (LCA) was applied to clinical data from 492 patients with left ventricular ejection fraction <50% who underwent PCI.
- Primary outcomes were all-cause mortality and heart failure (HF) hospitalization.
- Phenotypes were characterized by clinical features, and outcomes were compared across groups.
Main Results:
- Three distinct ICM phenotypes were identified.
- Phenotype 1: severe chronic kidney disease, hemodialysis (n=101). Phenotype 2: male, early-onset ICM, lifestyle diseases, high BMI (n=192). Phenotype 3: older adults, atrial fibrillation, mitral regurgitation, high BNP (n=199).
- Phenotype 2 had significantly lower combined mortality and HF hospitalization risk. LVRR was associated with better outcomes only in Phenotype 3.
Conclusions:
- Distinct clinical outcomes and LVRR patterns exist across ICM phenotypes post-PCI.
- These findings suggest underlying mechanisms vary among ICM phenotypes.
- Personalized treatment strategies targeting specific ICM phenotypes may improve outcomes.
Background:
Percutaneous coronary intervention (PCI) is a good option for patients with ischemic cardiomyopathy (ICM) at high operative risk. However, evidence shows little benefit of PCI, potentially due to heterogeneity in ICM. Here, we applied latent class analysis (LCA) to clinical data to characterize ICM phenotypes based on clinical features and to assess differences in clinical outcomes.
Methods And Results:
LCA was performed on data from 492 patients with a left ventricular (LV) ejection fraction <50% who underwent PCI. Primary outcomes included all-cause mortality and heart failure (HF) hospitalization. The optimal number of clinical phenotypes was 3. Phenotype 1 (n=101) was characterized by severe chronic kidney disease and a high frequency of hemodialysis. Phenotype 2 (n=192) included men with early-onset ICM, a high frequency of lifestyle-related diseases, and a high body mass index. Phenotype 3 (n=199) included older adults with a high prevalence of atrial fibrillation, moderate/severe mitral regurgitation, and high B-type natriuretic peptide levels. The risk of combined all-cause mortality and HF hospitalization was significantly lower for Phenotype 2 than the other phenotypes. LV reverse remodeling (LVRR) was associated with a lower incidence of the primary outcome in Phenotype 3, but not in the other phenotypes.
Conclusions:
We identified differences in clinical outcomes and LVRR across clinical ICM phenotypes after PCI, suggesting distinct underlying mechanisms across ICM phenotypes that may benefit from targeted treatments.
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