Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes

PLoS One

Damien Voilliot¹  Batric Popovic¹  Nelly Agrinier²  Jean Pierre Villemot³  Pablo Maureira³  Mazen Elfarra³ 

[1] CHU Nancy, Département de Cardiologie, Nancy, France;CHU Nancy, Epidémiologie et Evaluation Cliniques, Nancy, France;CHU Nancy, Service de chirurgie des maladies cardiovasculaires et transplantations, Nancy, France

关键词: Coronary revascularization;    Surgical and invasive medical procedures;    Coronary artery bypass grafting;    Chronic obstructive pulmonary disease;    Heart failure;    Death rates;    Renal ischemia;    Prognosis;   

DOI  :  10.1371/journal.pone.0168634

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Background Patients with non-ST elevation acute coronary syndrome complicated by left ventricular dysfunction (LVEF) are a poor prognosis group. The aim of our study was to assess the short and long term LEVF prognostic value in a cohort of NSTE-ACS patients undergoing surgical revascularization. Methods We performed elective and isolated CABG on a cohort of 206 consecutive patients with LVEF≤0.40 complicating acute coronary syndrome. The case cohort was compared with a cohort of controls (LVEF>0.40) randomly selected (2:1) among patients who underwent the procedure during this period. Results The Kaplan-Meier 5-year estimated survival rates for patients in the low and normal LVEF groups were 70.8% (95% confidence interval CI: 64.2–77.4) and 81.7% (95%CI: 77.8–85.6), respectively. A low LVEF was associated with both a higher all-cause (HR [95%CI] = 1.84[1.18–2.86]) and a higher cardiovascular mortality (HR = 2.07 [1.27–3.38]) during the first 12 months of follow-up. After adjustment for potential confounders, a low LVEF remained associated with a higher cardiovascular mortality only (1.87[1.03–3.38]) during the first 12 months of follow-up. After 12 months of follow-up, a low LVEF was no more associated with all-cause, nor cardiovascular mortality. Conclusion Patients with low LVEF might require more intensive care than patients with normal LVEF during the year after the surgical procedure, but once the first postoperative year over, the initial low LVEF was no more associated with long term mortality.

【 授权许可】

CC BY