Short- and long-term outcomes of percutaneous coronary interventions in patients with severe left ventricular dysfunction

AIMS: Poor left ventricular function is considered a high risk condition for performing either percutaneous (PCI) or surgical revascularisation. The aim of this study was to evaluate immediate and long term results of PCI in patients with coronary artery disease (CAD) and severe left ventricular dysfunction (EF < 0.30). METHODS AND RESULTS: Seventy-eight consecutive patients with CAD and severe left ventricular dysfunction (EF < 30%) were selected. The majority of these patients (87%) had multivessel disease. Coronary angioplasty procedure was mainly motivated by angina associated with clinical manifestation of heart failure (54%). Total number of treated vessels was 181, and a total of 203 stents were implanted (2.6 stent/patient). Procedural success was achieved in 77 patients (97.8%). The total procedural and in-hospital adverse event rate was 7.8%. Mean follow-up period (FU) was 25+/-6 months. Event-free survival rate at the end of FU was 55%; repeat revascularisation was performed in 21 patients (27.6%). Female gender, diabetes, new acute myocardial infarction and number of treated vessels were independent predictors for death and combined mayor adverse cardiac events (MACE) during the follow-up. CONCLUSIONS: In symptomatic patients with CAD and severe left ventricular dysfunction, PCI can be performed with excellent procedural outcome and acceptable long-term morbidity and mortality.