Outcomes of Percutaneous Coronary Intervention in Patients with Chronic Total Occlusions and Reduced Ejection Fraction | ||
| Benha Journal of Applied Sciences | ||
| Article 5, Volume 7, Issue 8, August 2022, Pages 31-37 PDF (754.55 K) | ||
| Document Type: Original Research Papers | ||
| DOI: 10.21608/bjas.2022.269900 | ||
| Authors | ||
| I A.Mohamed1; k E.Elrabat2; A Y.Ibrahim2; M M.Mandour1 | ||
| 1Cardiology, National Heart Institute, Cairo, Egypt | ||
| 2Cardiology, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||
| Abstract | ||
| The high incidence of chronic complete occlusion (CTO) of the coronary arteries in individuals with coronary artery disease has garnered a lot of interest (CAD). Long-term results are poorer for patients with CTO and reduced LVEF (left ventricular ejection fraction). Despite advances in other treatment modalities, percutaneous coronary intervention (PCI) continues to be the gold standard for individuals with a decreased LVEF. The purpose of this research was to analyse the influence of LV dysfunction on the results of Percutaneous coronary intervention (PCI) in patients with a lower LV ejection fraction (LVEF). Techniques Patients with CTO were recruited to the cardiac catheterization laboratory unit for elective PCI in this prospective trial. Group I (normal LVEF group) included patients with a baseline LVEF of at least 50%; group II (mid-range LVEF group) included patients with a baseline EF of 40% to 49%; and group III (reduced LVEF group) included patients with a baseline EF of 30% to 39%. There were a total of 120 patients in this trial; 40 were randomly assigned to each group. In terms of coronary intervention, there were no significant differences in procedure time (p=0.97), Syntax score (p=0.9), J-CTO score (p=0.41), wire technique (p=0.61), or wire stiffness (p=0.9), but contrast volume was significantly lower in the reduced LVEF group compared to the other groups (p=0.004). In the normal LVEF group, 87.5 percent of patients had successful PCI, in the intermediate LVEF group, 82.5 percent, and in the decreased LVEF group, 75.0 percent. There wasn't enough of a difference to warrant statistical attention. Pre-existing conditions including diabetes mellitus and the J-CTO score emerged as major contributors to the probability of periprocedural complications in the regression analysis. Our results show that CTO PCI is safe and effective even in patients with LV dysfunction. In these individuals, PCI led to better outcomes on clinical and LV echocardiographic functional measures. The incidence of major adverse cardiac and cerebrovascular events (MACCE) was similar in the three groups, therefore this improvement did not come at the price of postoperative safety. | ||
| Keywords | ||
| Chronic total occlusion; percutaneous coronary intervention; coronary artery disease; left ventricular ejection fraction | ||
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