계명대학교 의학도서관 Repository

Impact of Left Ventricular Ejection Fraction on Procedural and Long-Term Outcomes of Bifurcation Percutaneous Coronary Intervention

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Author(s)
Guglielmo GalloneJeehoon KangFrancesco BrunoJung-Kyu HanOvidio De FilippoHan-Mo YangMattia DoronzoKyung-Woo ParkGianluca MittoneHyun-Jae KangRadoslaw ParmaHyeon-Cheol GwonEnrico CerratoWoo Jung ChunGrzegorz SmolkaSeung-Ho HurGerard HelftSeung Hwan HanSaverio MuscoliYoung Bin SongFilippo FiginiKi Hong ChoiGiacomo BoccuzziSoon-Jun HongDaniela TrabattoniChang-Wook NamMassimo GiammariaHyo-Soo KimFederico ConrottoJavier EscanedCarlo Di MarioFabrizio D'AscenzoBon-Kwon KooGaetano Maria de Ferrari
Keimyung Author(s)
Hur, Seung HoNam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Am J Cardiol
Issued Date
2022
Volume
172
Abstract
The association of left ventricular ejection fraction (LVEF) with procedural and long-term outcomes after state-of-the-art percutaneous coronary intervention (PCI) of bifurcation lesions remains unsettled. A total of 5,333 patients who underwent contemporary coronary bifurcation PCI were included in the intercontinental retrospective combined insights from the unified RAIN (veRy thin stents for patients with left mAIn or bifurcatioN in real life) and COBIS (COronary BIfurcation Stenting) III bifurcation registries. Of 5,003 patients (93.8%) with known baseline LVEF, 244 (4.9%) had LVEF <40% (bifurcation with reduced ejection fraction [BIFrEF] group), 430 (8.6%) had LVEF 40% to 49% (bifurcation with mildly reduced ejection fraction [BIFmEF] group) and 4,329 (86.5%) had ejection fraction (EF) ≥50% (bifurcation with preserved ejection fraction [BIFpEF] group). The primary end point was the Kaplan-Meier estimate of major adverse cardiac events (MACEs) (a composite of all-cause death, myocardial infarction, and target vessel revascularization). Patients with BIFrEF had a more complex clinical profile and coronary anatomy. No difference in procedural (30 days) MACE was observed across EF categories, also after adjustment for in-study outcome predictors (BIFrEF vs BIFmEF: adjusted hazard ratio [adj-HR] 1.39, 95% confidence interval [CI] 0.37 to 5.21, p = 0.626; BIFrEF vs BIFpEF: adj-HR 1.11, 95% CI 0.25 to 2.87, p = 0.883; BIFmEF vs BIFpEF: adj-HR 0.81, 95% CI 0.29 to 2.27, p = 0.683). BIFrEF was independently associated with long-term MACE (median follow-up 21 months, interquartile range 10 to 21 months) than both BIFmEF (adj-HR 2.20, 95% CI 1.41 to 3.41, p <0.001) and BIFpEF (adj-HR 1.91, 95% CI 1.41 to 2.60, p <0.001) groups, although no difference was observed between BIFmEF and BIFpEF groups (adj-HR 0.87, 95% CI 0.61 to 1.24, p = 0.449). In conclusion, in patients who underwent PCI of a coronary bifurcation lesion according to contemporary clinical practice, reduced LVEF (<40%), although a strong predictor of long-term MACEs, does not affect procedural outcomes.
Keimyung Author(s)(Kor)
허승호
남창욱
Publisher
School of Medicine (의과대학)
Citation
Guglielmo Gallone et al. (2022). Impact of Left Ventricular Ejection Fraction on Procedural and Long-Term Outcomes of Bifurcation Percutaneous Coronary Intervention. Am J Cardiol, 172, 18–25. doi: 10.1016/j.amjcard.2022.02.015
Type
Article
ISSN
0002-9149
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0002914922001692
DOI
10.1016/j.amjcard.2022.02.015
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44275
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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