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GW23-e2116
SHORT- AND LONG-TERM OUTCOMES OF CORONARY REVASCULARISATION IN PATIENTS WITH SEVERE LEFT VENTRICULAR DILATATION
  1. Xiao Wang,
  2. Shaoping Nie,
  3. Changsheng Ma,
  4. Xiaohui Liu,
  5. Jianzeng Dong,
  6. Xin Du,
  7. Rong Hu,
  8. Junping Kang,
  9. Qiang Lv,
  10. Xinmin Liu,
  11. Fang Chen,
  12. Shuzheng Lv,
  13. Shaoping Nie
  1. Beijing Anzhen Hospital, Capital Medical University

    Abstract

    Objectives Patients with coronary artery disease accompanied by severe left ventricular dilatation (LVD) are at higher risk for heart failure and death. However, their clinical and angiographic profiles, short- and long-term outcomes after revascularisation are unknown.

    Methods A total of 4283 patients (median age 60.0 years; 77.4% male) undergoing coronary revascularisation in our centre from July 2003 to September 2005 were stratified according to end-diastolic dimension (EDD). Patients with severe LVD (EDD>70 mm), mild/moderate LVD (EDD 52.7 mm to 70.0 mm in males, EDD 48.3 mm to 70.0 mm in females), and no LVD (EDD<52.7 mm in males, EDD<48.3 mm in females) was compared for outcome analysis.

    Results Patients with severe LVD had more complex lesions (eg, chronic total occlusions, multi-vessel disease) with more prior myocardial infarction, valvular impairments and renal dysfunction (all p<0.001). Patients successfully discharged were followed up for a median of 548 (455–669) days. Severe LVD was significantly associated with increased in-hospital mortality (5.4% vs 1.6% vs 1.0%, p<0.001) and composite ischaemia (6.9% vs 2.5% vs 2.1%, p<0.001) compared with mild/moderate LVD and no LVD groups. By multivariable analysis, severe LVD was a significant independent predictor of in-hospital (HR 1.858, 95% CI 1.323 to 2.611, p<0.001) and follow-up mortality (HR 1.697, 95% CI 1.253 to 2.298, p=0.001) after revascularisation.

    Conclusions Patients with severe LVD have more co-morbidities and complex coronary lesions. Severe LVD in patients undergoing coronary revascularisation was an independent predictor of early and late mortality and adverse ischaemic outcomes.

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