Why the study?
Does left anterior descending coronary artery stenting improve left ventricular ejection fraction and myocardial perfusion in patients undergoing successful PCI?
Does left anterior descending coronary artery stenting improve left ventricular ejection fraction and myocardial perfusion in patients undergoing successful PCI?
Successful LAD stenting is associated with improved left ventricular ejection fraction at 6 months, with greater recovery observed in patients receiving larger diameter stents (>3 mm).
Should not yet change PCI practice; leaves open whether LAD stenting improves LVEF or larger stents enhance recovery.
Our objective was to determine the factors affecting recovery of left ventricular (LV) contractility and myocardial perfusion after percutaneous coronary intervention (PCI). We selected 60 consecutive patients who underwent successful left anterior descending coronary artery (LAD) stenting. The mean stent diameter and length were 3.37+/-0.47 mm and 17.4+/-6 mm, respectively. Supporting a functional impact of successful PCI, myocardial perfusion and LV ejection fraction (LVEF) improved at 6+/-3 months after the procedure (48.8+/-11.6% vs 52.5+/-11.5%, P=0.05). Patient related factors such as diabetes mellitus, presentation with acute coronary syndrome, and age did not seem to affect LVEF change after the procedure. On univariate analysis, the change in LVEF after PCI was only related to the stent diameter. The increase in LVEF was higher in patients who received a stent>3 mm in diameter (P=0.041). There was a weak but statistically positive correlation between the stent diameter and the LVEF change after the procedure (R=0.267, P=0.049). Other procedure related factors such as multivessel PCI or stent length did not affect the percent ejection fraction change after stenting.
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Ağırbaşlı et al. (2005) studied this question.
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