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Worsening LV function may predict 30-day, long-term mortality after PCI
Researchers for a new study suggest that there is an independent relationship between worsening left ventricular function and mortality across all indications for PCI.
LV dysfunction has been reported in about 10% to 30% of patients undergoing PCI, according to background information in the study. This prompted researchers in the United Kingdom to investigate the effect of LV function on early and late mortality outcomes after PCI.
The cohort included 230,464 patients accrued from the British Cardiovascular Intervention Society data set from 2006 to 2011. Individuals undergoing elective PCI along with those undergoing the procedure for STEMI and non-STEMI indications were included. The primary endpoint was 30-day mortality.
Moderate LV function, defined as ejection fraction of 30% to 49%, yielded an increase in 30-day mortality risk when compared with good LV function, defined as ejection fraction >50% (HR=2.91; 95% CI, 2.43-3.49). Poor LV function (ejection fraction <30%) also was associated with an increased mortality risk compared with good LV function (HR=7.25; 95% CI, 5.87-8.96).
Poor LV function independently predicted increases in 30-day mortality among patients who underwent elective PCI (HR=3.72; 95% CI, 2.21-6.25), as well as those with indications for STEMI (HR=8.18; 95% CI, 5.62-11.92) and non-STEMI (HR=5.03; 95% CI, 3.64-6.93).
These data support “historical reports of an association between reduced LV function and increased in-hospital mortality,” the researchers concluded. “Our findings complement earlier studies and suggest that the assessment of LV function should be undertaken where possible prior to PCI, especially considering the importance of LV function in contemporary risk stratification scores to enable more accurate quantification of risk.”
Disclosure: The researchers report no relevant financial disclosures.