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The following is a summary of “Left ventricular systolic function after percutaneous coronary intervention: patterns of change and prognosis according to clinical presentation of coronary artery disease,” published in the December 2024 issue of Cardiology by Ndrepepa et al.    

The relationship between changes in left ventricular ejection fraction (ΔLVEF) following percutaneous coronary intervention (PCI) and long-term prognosis across different coronary artery disease (CAD) presentations remains unclear.  

Researchers conducted a retrospective study to assess ΔLVEF change after PCI and its association with 5-year mortality in various CAD presentations.  

They included 8,181 patients with paired LVEF measurements before and 6–8 months after PCI, 4,582 with chronic coronary disease (CCD), 1,972 with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and 1,627 with ST-segment elevation myocardial infarction (STEMI), ΔLVEF was classified as decline (<0%), moderate improvement (0% to <10%), or significant improvement (≥10%), primary outcome was 5-year mortality.  

The results showed that the median ΔLVEF in patients with CCD, NSTE-ACS, and STEMI was 0.0% [−3.0%; 4.0%], 1.0% [−2.0%; 5.0%], and 3.0% [−2.0%; 10.0%], respectively (P<0.001). In patients with a decline, moderate improvement, and significant improvement in LVEF, 5-year mortality was 10.0%, 10.4%, and 12.3% in patients with CCD, 10.8%, 10.7%, and 18.1% in patients with NSTE-ACS, and 10.6%, 8.2%, and 5.2% in STEMI. After adjustment, ΔLVEF was associated with 5-year mortality in patients with CCD (aHR] = 0.90, 95% CI [0.83–0.97]) and STEMI (aHR = 0.85 [0.75–0.95]), but not in NSTE-ACS (aHR = 0.97 [0.85–1.10]), with all HRs calculated for a 5% increment in ΔLVEF.  

They concluded that the type of CAD affects both changes in ΔLVEF after PCI and the association with 5-year mortality.  

Source: link.springer.com/article/10.1007/s00392-024-02588-y