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[Immediate and long-term results of coronary angioplasty in patients with low ejection fraction]
1Service de cardiologie, hôpital Charles-Nicolle, Rouen.
Insights
This study found that coronary angioplasty has a high success rate in patients with reduced left ventricular ejection fraction. However, survival is significantly correlated with the initial ejection fraction, highlighting its importance in coronary artery disease management.
Area of Science:
- Cardiology
- Interventional Cardiology
Context:
- Left ventricular function is crucial for survival in coronary patients.
- Coronary bypass surgery outcomes in left ventricular dysfunction are well-documented.
- Coronary angioplasty offers an alternative revascularization strategy.
Purpose:
- To evaluate the success rate, risks, and clinical outcomes of coronary angioplasty in patients with severely reduced left ventricular ejection fraction (< or = 35%).
Summary:
- Retrospective study of 182 patients with ejection fraction <= 35% (average 30%).
- Primary angioplasty success rate was 95% with 7.1% major complications (including 7 deaths).
- At 32-month follow-up, 25% mortality was observed, with ejection fraction being the sole significant predictor of survival.
Impact:
- Coronary angioplasty is a feasible revascularization option for selected patients with impaired left ventricular function.
- Ejection fraction remains a critical prognostic indicator in this high-risk population.
- Further research may optimize patient selection and post-procedure management to improve long-term survival.
Abstract:
Left ventricular function is the main predictive factor for survival in coronary patients and the results of coronary bypass surgery in left ventricular dysfunction have been widely reported. The authors undertook a retrospective study of the success rate, the risks and clinical outcome after coronary angioplasty of 182 patients with a left ventricular ejection fraction < or = 35% (30 +/- 4%). The average age was 61 +/- 10 years and 78% were men. One hundred and fifty three patients had a history of myocardial infarction. The primary success rate of angioplasty was 95% (271/284 lesions) including the multiple procedures in 24% of cases. There was a 7.1% frequency of major complications (7 deaths, 3 non-Q wave infarctions, 4 emergency coronary bypass procedures). An average follow-up period of 32 months was obtained in 98.4% of patients. Seven patients developed a myocardial infarction and 14 patients were rehospitalized for cardiac failure (N = 6) or severe ventricular arrhythmias (N = 8). A control coronary angiography was performed in 100 cases either as a routine investigation or for recurrence of symptoms. Restenosis was demonstrated in 33 cases, an aggravation of lesions on another vessel in 12 cases and restenosis associated with aggravation of other lesions in 5 cases, leading to redilatation in 26 cases, atherectomy in 2 cases and coronary bypass surgery in 16 cases. Forty-one patients died (25%). Ten patients died before the 6th month and 31 died secondarily. The only parameter which was significantly correlated with survival was the value of the ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)