Coronary Revascularization Improves EF and reduces mortality and HF related hospitalization
Heart failure is a major and growing public health issue worldwide. With the ageing population and advancements in medical and surgical treatments, the prevalence of heart failure is projected to rise globally in the foreseeable future. A recent study suggests that improvements in LV function after revascularization is associated with better long-term outcomes. The study findings were published in the journal Circulation: Cardiovascular Interventions on April 12, 2022.
Coronary revascularization is recommended to treat ischemic cardiomyopathy. However, the relations of revascularization-associated ejection fraction (EF) change to subsequent outcomes has not been elucidated. Therefore, Dr Jacob Joseph and his team conducted a study to evaluate the link between revascularization-associated EF and subsequent outcomes.
In this study, the researchers assessed data of 10 071 veterans who underwent a first percutaneous coronary intervention (PCI) or coronary artery bypass grafting between January 1, 1995, and December 31, 2010, and had pre-revascularization and post-revascularization EF measured. They calculated delta-EF (post-procedure EF–pre-procedure EF). They further related delta-EF as a continuous measure and as categories
Key findings of the study:
- Upon follow-up (mean/maximum 5/14 years), the researchers noted that 56% died.
- They found that each 5% improvement in delta-EF was associated with statistically significant reductions in death and heart failure hospitalization days of 5% and 10% respectively, in the total sample and they further noted a 6% and 10% in the PCI subgroup.
- They observed that patients in the highest delta-EF category had 27% lower mortality (30% lower in PCI stratum) and ≈40% lower heart failure hospitalization days in the total sample and PCI stratum compared with those in the lowest category.
- They noted that the relations between delta-EF and outcomes in the coronary artery bypass grafting subgroup did not reach statistical significance.
The authors concluded, "Revascularization-associated EF improvement was associated with significant reductions in mortality and heart failure hospitalization burden, particularly in the PCI subgroup."
For further information:
DOI: https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.121.011284
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