Document Detail


Impact of left ventricular dysfunction on hospital mortality among patients undergoing elective percutaneous coronary intervention.
MedLine Citation:
PMID:  19166689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Many patients with systolic dysfunction undergo elective percutaneous coronary intervention (PCI) despite the unknown risk and limited data supporting its use. Therefore, the aim of this study was to evaluate the association between the severity of left ventricular (LV) systolic dysfunction and hospital mortality in patients who undergo elective PCI. A retrospective cohort study was conducted of all patients who underwent elective PCI in New York State in 1998 and 1999. Patients were stratified into 5 groups on the basis of their LV ejection fractions (EFs) before PCI (>55%, 46% to 55%, 36% to 45%, 26% to 35%, and < or =25%). Comparisons of demographic, procedural, and outcome variables were performed, and adjusted odds ratios (ORs) were calculated to evaluate the relation between the EF and hospital mortality. Among 55,709 patients who underwent elective PCI, EFs < or =25%, 26% to 35% and 36% to 45% were present in 3.4%, 7.6%, and 17.4%, respectively. Hospital mortality was 0.3%, 0.2%, 0.6%, 1.2%, and 2.7% in the groups with EFs >55%, 46% to 55%, 36% to 45%, 26% to 35%, and < or =25%, respectively (p <0.001). After multivariate adjustment, an increased risk for hospital mortality was significant for EF groups of 36% to 45% (OR 1.56, 95% confidence interval 1.06 to 2.30), 26% to 35% (OR 2.17, 95% confidence interval 1.42 to 3.31), and < or =25% (OR 3.85, 95% confidence interval 2.46 to 6.01) compared with EF >55%, respectively. In conclusion, this analysis demonstrates that elective PCI is commonly performed in patients with reduced EFs, and the risk for hospital mortality increases as the EF decreases. For patients who undergo elective PCI, an EF < or =45% is associated with higher adjusted hospital mortality. Whether elective PCI in patients with low EFs reduces morbidity and/or mortality over medical therapy alone is unknown.
Authors:
Thomas W Wallace; Jeffrey S Berger; Andrew Wang; Eric J Velazquez; David L Brown
Related Documents :
22146199 - Perioperative morbidity and mortality of 2-team simultaneous bilateral total knee arthr...
19549619 - Dual antiplatelet therapy for more than 12 months after percutaneous coronary intervent...
20571249 - Comparison of long-term prognostic evaluation between pre-intervention thrombolysis and...
17696619 - Sirolimus-eluting versus bare-metal low-profile stent for renal artery treatment (great...
24380609 - Prophylactic ampicillin versus cefazolin for the prevention of post-cesarean infectious...
11181469 - Treatment of reinfarction after thrombolytic therapy for acute myocardial infarction: a...
12077689 - Endoscopic saphenous vein harvesting for cabg -- a randomized, prospective trial.
8447209 - Doxapram improves pulmonary function after upper abdominal surgery.
12361079 - Prospective evaluation of quality of life after oncologic surgery for oral cancer.
Publication Detail:
Type:  Journal Article     Date:  2008-11-17
Journal Detail:
Title:  The American journal of cardiology     Volume:  103     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-60     Citation Subset:  AIM; IM    
Affiliation:
Duke University Medical Center, Durham, NC, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / mortality*
Coronary Disease / complications,  mortality,  therapy*
Female
Hospital Mortality*
Humans
Male
Middle Aged
Surgical Procedures, Elective
Ventricular Dysfunction, Left / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Relation of high-density lipoprotein cholesterol to mortality after percutaneous coronary interventi...
Next Document:  Alcohol drinking and cardiovascular risk in a population with high mean alcohol consumption.