PMID- 36896424
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230311
IS  - 2090-8016 (Print)
IS  - 2090-0597 (Electronic)
IS  - 2090-0597 (Linking)
VI  - 2023
DP  - 2023
TI  - The Impact of Complete Revascularization in Symptomatic Severe Left Ventricular 
      Dysfunction between Coronary Artery Bypass Graft and Percutaneous Coronary 
      Intervention.
PG  - 9226722
LID - 10.1155/2023/9226722 [doi]
LID - 9226722
AB  - OBJECTIVE: The study aimed to compare the clinical outcomes between the patients 
      receiving coronary artery bypass surgery (CABG) or percutaneous coronary 
      intervention (PCI) for the patients with symptomatic severe left ventricular (LV) 
      dysfunction and coronary artery disease (CAD). METHODS: Between February 2007 and 
      February 2020, a total of 745 patients who received coronary artery angiography 
      for reduced LV ejection fraction (LVEF) < 40% and symptomatic New York Heart 
      Association (NYHA) functional class >/= 3 were recruited. The patients (N = 236) 
      who were diagnosed with dilated cardiomyopathy or valvular heart disease without 
      coronary artery stenosis, those with prior history of CABG or valvular surgery 
      (N = 59), those who presented ST-segment elevated myocardial infarction (STEMI), 
      those with a CAD and SYNTAX score of  <== 22 (N = 175), those who received emergent 
      CABG for coronary perforation (N = 3), and those who had NYHA class <== 2 (N = 65) 
      were excluded. Finally, 116 patients with reduced LVEF and those who had a SYNTAX 
      score >22, who received CABG (N = 47) and PCI (N = 69), were recruited for this 
      study. RESULTS: There was no significant difference in the incidence values of 
      in-hospital course and those of in-hospital mortality, acute kidney injury, and 
      postprocedural hemodialysis. There was no significant difference in the 
      1-yearfollow-up of recurrent MI, revascularization, or stroke between the groups. 
      The 1-year heart failure (HF) hospitalization rate was significantly lower in the 
      CABG group than in all patients of the PCI group (13.2% vs. 33.3%; p = 0.035); 
      however, there was no significant difference in the same variable between the 
      CABG group and the complete revascularization subgroup (13.2% vs. 28.2%; p = 
      0.160). The revascularization index (RI) was significantly higher in the CABG 
      group than in all patients of the PCI group or complete revascularization 
      subgroup (0.93 +/- 0.12 vs. 0.71 +/- 0.25; p < 0.001) and (0.93 +/- 0.12 vs. 
      0.86 +/- 0.13; p = 0.019). The 3-year HF hospitalization rate was significantly 
      lower in the CABG group than in all patients of the PCI group (16.2% vs. 42.2%; p 
      = 0.008); however, there was no difference in the same variable between the CABG 
      group and the complete revascularization subgroup (16.2% vs. 35.1%; p = 0.109). 
      CONCLUSIONS: In patients with symptomatic (NYHA class >/= 3) severe LV dysfunction 
      and CAD, CABG brought less HF admission when compared to patients in the PCI 
      group, but this did not differ when compared to the complete revascularization 
      subgroup. Therefore, an extensive revascularization, achieved by CABG or PCI, is 
      associated with a lower HF hospitalization rate during the 3-yearfollow-up period 
      in such populations.
CI  - Copyright (c) 2023 Hsiu-Yu Fang et al.
FAU - Fang, Hsiu-Yu
AU  - Fang HY
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
AD  - Division of Cardiology, Department of Internal Medicine, Jen-Ai Hospital, 
      Taichung, Taiwan.
FAU - Fang, Yen-Nan
AU  - Fang YN
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
FAU - Chen, Yin-Chia
AU  - Chen YC
AD  - Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung 
      Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
FAU - Sheu, Jiunn-Jye
AU  - Sheu JJ
AD  - Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung 
      Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
FAU - Lee, Wei-Chieh
AU  - Lee WC
AUID- ORCID: 0000-0003-0585-6134
AD  - Institute of Clinical Medicine, College of Medicine, National Cheng Kung 
      University, Tainan, Taiwan.
AD  - Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, 
      Tainan, Taiwan.
AD  - School of Medicine, College of Medicine, National Sun Yat-sen University, 
      Kaohsiung, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20230228
PL  - United States
TA  - Cardiol Res Pract
JT  - Cardiology research and practice
JID - 101516542
PMC - PMC9991473
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2023/03/11 06:00
MHDA- 2023/03/11 06:01
PMCR- 2023/02/28
CRDT- 2023/03/10 02:43
PHST- 2022/08/03 00:00 [received]
PHST- 2023/02/15 00:00 [revised]
PHST- 2023/02/16 00:00 [accepted]
PHST- 2023/03/10 02:43 [entrez]
PHST- 2023/03/11 06:00 [pubmed]
PHST- 2023/03/11 06:01 [medline]
PHST- 2023/02/28 00:00 [pmc-release]
AID - 10.1155/2023/9226722 [doi]
PST - epublish
SO  - Cardiol Res Pract. 2023 Feb 28;2023:9226722. doi: 10.1155/2023/9226722. 
      eCollection 2023.