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Association Between Revascularization and 30-Day Survival of Ischemic Cardiomyopathy Patients in Dr. Hasan Sadikin
Pradana Pratomo Raharjo1, Adrian Sebastian Suhendro1, Achmad Fauzi Yahya1
1Department of Cardiology and Vascular Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Insights
Revascularization procedures like PCI and CABG did not show an association with 30-day survival in ischemic cardiomyopathy patients. Further research is needed due to wide confidence intervals in this study.
Area of Science:
- Cardiology
- Vascular Medicine
- Heart Failure Research
Background:
- Ischemic cardiomyopathy is a primary cause of heart failure, leading to significant morbidity and mortality.
- The impact of percutaneous coronary intervention (PCI) on survival outcomes in ischemic cardiomyopathy requires further clarification.
Purpose of the Study:
- To assess the association between revascularization procedures and 30-day survival rates in patients with ischemic cardiomyopathy.
- This evaluation was conducted at Dr. Hasan Sadikin General Hospital.
Main Methods:
- A retrospective cohort study analyzed data from 67 ischemic cardiomyopathy patients undergoing revascularization (CABG or PCI) between January 2021 and December 2022.
- Kaplan-Meier analysis, log-rank tests, and Cox regression models were employed for survival analysis, including multivariate analysis for confounding factors.
Main Results:
- While the CABG group had a higher proportion of younger patients and complete revascularization, the PCI group showed a higher 30-day survival rate (97.5% vs. 81.5%).
- Multivariate analysis indicated no statistically significant association between revascularization and 30-day survival after adjusting for confounders (aHR=4.02, p=0.31).
Conclusions:
- Revascularization in ischemic cardiomyopathy patients at this institution was not significantly associated with 30-day survival.
- Wide confidence intervals in the analysis suggest uncertainty, underscoring the need for more extensive research.
Introduction:
Ischemic cardiomyopathy is the leading cause of heart failure and associated with increased morbidity and mortality. The role of percutaneous coronary intervention (PCI) in term of increasing survival and cardiovascular outcomes in ischemic cardiomyopathy remains unclear.
Purpose:
To evaluate whether revascularization is associated with 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital.
Patients And Methods:
This was a single center, observational, retrospective cohort study. Subject data was taken from the CABG and PCI database of Cardiology and Vascular Medicine Department, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital from January 2021 to December 2022. Study outcome was 30-day survival after revascularization procedure. Survival analysis was done using Kaplan-Meier analysis then bivariate analysis with log rank test and cox regression analysis. Cox regression analysis was also done for multivariate analysis of confounding factors.
Results:
A total of 67 ischemic cardiomyopathy patients were included in the final analysis of this study with balance proportion except for age, complete revascularization, and chronic total occlusion (CTO) variables. CABG group tends to be younger with more proportion in age ≤65 years old compared with PCI group (92.6% vs. 65%. p = 0.01). Complete revascularization had reached dominantly in the CABG group compared with PCI group (85.2% vs. 15%. p < 0.001). In coronary anatomy characteristic, CTO was found more in the CABG group (81.5% vs. 52.5%. p = 0.02). In 30-day follow up, overall survival rate was 91% with 81.5% in the CABG group compared with 97.5% in the PCI group (p = 0.03). Multivariate analysis was done to exclude confounding factors with adjusted hazard ratio of revascularization was 4.02 (CI95% 0.27-60.3. p = 0.31).
Conclusion:
There is no association between revascularization and 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital. However, wide confidence intervals highlight uncertainty.
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