Outcomes After PCI in Patients with LV Dysfunction

Background: Coronary artery disease (CAD) is the most common cause of left ventricular dysfunction. Percutaneous coronary intervention (PCI) in patient with LV dysfunction is a high risk procedure and may be associated with adverse outcomes. We observed for outcomes after PCI in the elective and acute coronary syndrome setting in patient with LV dysfunction. Methods: A prospective single center study was performed in 836 patients with and without LV dysfunction who underwent PCI with a follow up period of 1 year for MACCE. Results: A total of 836 patients were studied. 329 (39.4%) patients have LV dysfunction (LVD) and 507 (60.6%) patients have good LV function (GLV). Among the patients with LVD, 160 (48.6%) has mild, 89 (27.1%) has moderate, 80 (24.3%) has severe LVD. Mean age was 56.5±12.5 years in patients with GLV and 58.8±10 years in LVD patients (p=0.003). Number of males were 259 (78.7%) in LVD and 364 (71.7%) in GLV group. Hypertension and diabetes were present in 237(72%) vs 368(72.5%), 168 (51%) vs 286 (56.4%) in LVD and GLV groups respectively (p=0.8, 0.1). There was no difference in the previous history of CABG (5.2% vs 3.4%, p=0.2) and PCI (19.5% vs 16.4%, p=0.3) in both groups. 174 (52.9%) patients with LVD and 409 (80.7%) patients with GLV has chronic stable angina. Multivessel PCI was done in 79 (24%) patients with LVD and 110 (21.7%) patients with GLV (p=0.4). Major adverse cardiovascular and cerebrovascular events (MACCE) occurred in 3 patients with mild, 5 patients with moderate, 6 patients with severe LVD during the follow up of 1 year. There was no difference in outcomes between the LVD and GLV group at one year (p=0.2), but when a subgroup analysis was made among patients with LV dysfunction there was a significant occurrence of MACCE in patients with severe LV dysfunction when compared with mild LVD (p=0.05). Conclusion: There was no significant difference between the occurrence of MACCE in patients with LV dysfunction and without LV dysfunction who underwent PCI. But when a subgroup analysis was done there was a significant occurrence of MACCE in patients with severe LV dysfunction (p=0.05) when compared to mild LVD.