Cruz OR, Palacios RJM, Muñiz GA, Reyes DS, Jáuregui OO, Ogaz GE

Language: Spanish
References: 16
Page: 95-99
PDF size: 78.94 Kb.

ABSTRACT

Background: Percutaneous revascularization in patients with ischemic heart disease has grown in such a way that it has extended its benefits to patients (pts) considered at a high risk level, among this group we include those with left ventricular systolic dysfunction. This study was done to identify the immediate and mediate term outcomes in ischemic patients with left ventricular systolic dysfunction taken to coronary interventionism. Methodology: We carried out this observational, retrospective, unicentric study, including pts who underwent to Percutaneous Coronary Angioplasty (PCTA) as a revascularization method, and having a left ventricular ejection fraction (LVEF) £ 40% from 1995 to 2003. Patients were divided in two groups, group A included pts with LVEF of 25%, and group B included those with LVEF From 26 to 40%. An analysis at intrahospitalary and sixth month follow up outcomes was made. Results: group A included 271 pts ns group B 230 pts. In group A most of them were men (92%) and the average age was 58 years, on the other hand group B included men in 74% and the average age was 60 years (p 0.0083). In the remaining basal characteristics there was a difference in arterial systemic hypertension prevalence being a 36% for group A and a 64% for group B. Regarding to the features such as type of lesson, treated artery, stent implantation, and procedure success here was not a significant difference among both groups. The intraaortic contrapulsation balloon (IACB) was used in 23% of cases in group A and in 5% of cases for group B (p 0.13). Thirty day and six month mortality rates were 13% and 15% for group A and 2.6% and 3% for group B (p 0.0014 and p 0.0064). Conclusions: PCTA in patients with ischemic heart disease, the presence of major adverse cardiovascular events such as mortality, in patients with ejection fraction < 25% mortality is higher.

REFERENCES

1. Dotter CT, Judkins MP. Transluminal treatment of arteriosclerotic obstruction: description of a new technic and a preliminary report of its application. Circulation 1964; 3: 654-670.

2. Gruentzing A, Hopff H. Die perkutane rekanalisation chronischer arterieller verschluesse mit einem neuen dilatationskatheter. Dtsch Med Wochenschr 1974; 99: 2502-2504.

3. Gruentzing A. Die perkutane rekanalisation chronischer arterieller verschluesse (Dotter prinzip) mit einem neuen doppelluminigen dilatationskatheter. Fortschr Roentgenstr 1976; 124: 80-86.

4. Gruentzing A, Sennig A, Siegenthaler W. Nonoperative dilatation of coronay-artery stenosis. Percutaneous transluminal coronary angioplasty. N Engl J Med 1979; 301: 61-68.

5. Meier B. The first patient to undergo coronary angioplasty-23 years follow up. N Engl J Med 2001; 344: 144-145.

6. Puel J, Joffre F, Rousseau H. Endo-protheses coronariennes auto-expensives dans la prevention des restenoses apres angioplastie transluminales. Arch Mal Coer 1987; 8: 1311-1312.

7. Block PC. Mechanism of transluminal angioplasty. Am J Cardiol 1984; 53: 69C–71C.

8. Hartzler GO, Rutherford BD, McConahay DR. “High risk” percutaneous transluminal coronary angioplasty. Am J Cardiol 1988; 61: 33G-37G.

9. Eltchaninoff H, Franco I, Whitlow PL. Late results of coronary angioplasty in patients with left ventricular ejection fractions < 40%. Am J Cardiol 1994; 73: 1047-52.

10. Franciosa JA, Wilen M, Ziesche S. Survival in men with severe chronic left ventricular failure due to Esther coronary Heart disease or idiopathic dilated cardiomyopathy. Am J Cardiol 1983; 51: 831-836.

11. Moussa I, Reimers B, Moses J. Long-term angiographic and clinical outcome of patients undergoing multivessel coronary stenting. Circulation 1997; 96: 3873-9.

12. Stevens T, Kahn JK, McCallister BD. Safety and efficacy of percutaneous transluminal coronary angioplasty in patients with left ventricular dysfunction. Am J Cardiol 1991; 68: 313-319.

13. Toda K, Mackenzie K, Mehra M. Revascularization in severe ventricular dysfunction (15% < LVEF < 30%): A comparison of bypass grafting and percutaneous intervention. Ann Thorac Surg 2002; 74: 2082-2087.

14. O´keefe JM, Allan JJ, McCallister BD. Angioplasty versus bypass surgery for multivessel coronary artery disease with left ventricular ejection fraction < 40%. Am J Cardiol 1993; 71: 897-901.

15. Patti G, D´Ambrosio A, Manzoli A. Coronary stenting in patients with left ventricular dysfunction: Acute outcome and long-term results. J Am Col Cardiol 200; CP145/10303.

16. Chalasari P, Weintraub Y, Shen Y. Improved in hospital outcome for patients with severe left ventricular dysfunction who undergo angioplasty. JACC 1998: 1164/103.