Why the study?
Data on long-term outcomes of PCI for LMCA disease, especially in patients with acute coronary syndrome, remain limited and conflicting.
Does left ventricular ejection fraction at admission predict immediate and 4-year mortality in ACS patients undergoing PCI for left main coronary artery disease?
Does left ventricular ejection fraction at admission predict immediate and 4-year mortality in ACS patients undergoing PCI for left main coronary artery disease?
In patients with acute coronary syndrome undergoing PCI for left main coronary artery disease, reduced LVEF at admission is a significant predictor of long-term (4-year) mortality.
Reduced LVEF was associated with higher 4-year mortality after LM PCI in ACS; supports risk stratification but leaves open causal inference and practice change.
Background: The treatment of LMCAD has shifted from coronary artery bypass grafting (CABG) to Percutaneous coronary intervention (PCI). However, data on long-term outcomes of PCI for LMCA disease, especially in patients with acute coronary syndrome (ACS) remains limited and conicting. This study aims to nd the association of the immediate and 4-year mortality in ACS patients with LMCA disease treated by PCI based on ejection fractions at admission. Methods: A retrospective analytical study was conducted. Patients were divided at admission into those with reduced left ventricular ejection fraction and those with preserved ejection fraction. Results: Forty (58.8%) of the patients presented with preserved EF. The mean age of the patients was 71.6±7.1 years. The mean LVEF of the preserved group was 61.6±4.3% and signicantly higher than that of the reduced group. Age and cardiovascular risk factor prole was similar between the two groups. Patients with reduced ejection fraction had signicantly higher levels of serum creatinine and signicantly lower levels of Hb and HDL. Mean hospital stay was signicantly longer for patients with preserved EF. In-hospital deaths were also similar between the two groups. The reduced EF group had a signicantly higher allcause mortality in the 4-year follow-up period. The mean years of follow-up for all participants was 4.2±1.3 years. Conclusion: It was seen that in patients presenting with ACS and undergoing PCI due to LMCAD, LVEF at admission, singly and in in multivariate regression is an important predictor of in hospital and 4-year mortality
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Mandal et al. (2021) studied this question.
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