Coronary Revascularization Improves EF and reduces mortality and HF related hospitalization

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