In-Hospital Outcome of Percutaneous Coronary Interventions in Patients with Left Ventricular Systolic Dysfunction

Background- Left ventricular dysfunction is considered a high-risk condition for performing either percutaneous or surgical revascularization. The aim of this study was to evaluate immediate procedural and clinical outcomes and in-hospital complications of percutaneous coronary interventions (PCI) in patients with coronary artery disease (CAD) and ventricular systolic dysfunction. Methods- Four hundred consecutive patients with documented obstructive CAD and left ventricular systolic dysfunction (EF <45%) were selected. Left ventricular ejection fraction was assessed via transthoracic echocardiography at the time of hospitalization. Indications for PCI were made on the basis of clinical and non-invasive studies. The majority of the patients (75%) were males, and their mean age was 55.9پ}10.7 years. More than half of the patients (56.78%) had multi-vessel disease. Multi-vessel PCI was performed in 51 (12.85%) patients. A total of 397 stents were implanted (0.99 stent/patient). Results- Technical procedural success was obtained in 96.75% of the patients. Procedural death was not seen. Non-Q wave acute myocardial infarction occurred in 12 (3%) patients, Q-wave AMI in four (1%), emergency coronary artery bypass grafting in six (1.5%), and cardiogenic shock in three (0.75%). Stroke did not occur in any cases. Major bleeding occurred in one (0.25%) patient, and 4.2% of the patients experienced minor bleeding. Conclusions- In patients with CAD and left ventricular systolic dysfunction, PCI can be performed with a good procedural outcome and acceptable in-hospital complications (Iranian Heart Journal 2008; 9 (4):13-18).