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Results of percutaneous coronary intervention in patients with chronic heart disease and chronic heart failure with reduced left ventricular ejection fraction

Authors: Sokolova N.Yu., Makhauri A.D., Medzhidov S.R., Martynova K.A.

Company: Tver State Medical University, Tver, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18-4-494-504

For citation: Sokolova N.Yu., Makhauri A.D., Medzhidov S.R., Martynova K.A. Results of percutaneous coronary intervention in patients with chronic heart disease and chronic heart failure with reduced left ventricular ejection fraction. Creative Cardiology. 2024; 18 (4): 494–504 (in Russ.). DOI: 10.24022/1997-3187-2024-18-4-494-504

Received / Accepted:  21.10. 2024 / 02.12.2024

Keywords: chronic ischemic heart disease heart failure left ventricular systolic dysfunction percutaneous coronary interventions optimal drug therapy

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Abstract

The aim. Comparative analysis of different treatment strategies: optimal medical therapy (OMT) and myocardial revascularization using PCI versus the strategy of isolated OMT in patients with chronic coronary artery disease and heart failure with reduced LVEF < 40%.

Material and methods. A single-center, prospective, observational, non-randomized study included 101 patients with chronic coronary artery disease and heart failure with LV systolic dysfunction (ejection fraction ≤40%). The average age of patients was 67.3±6.4 years. Patients were selected into 2 groups corresponding to the strategies: PCI against the background of OMT (PCI group, n=48, 47.5%) and isolated optimal medical therapy (OMT group, n=53, 52.5%). The primary endpoints of the study were hospitalization for CHF within 12 months, death (from all causes and cardiac mortality). Secondary endpoints were non-fatal myocardial infarction, unplanned myocardial revascularization within 12 months, quality of life.

Results. In the long-term period the following was obtained: the frequency of hospitalization due to CHF (PCI with OMT (n=5, 10.4%) versus OMT (n=9, 17.0%), respectively, p=0.34); overall mortality (PCI with OMT (n=6, 12.5%) versus OMT (n=10, 18.9%), respectively, p=0.36); cardiac mortality (PCI with OMT (n=3, 6.3%) versus OMT (n=7, 13.2%), respectively, p=0.24); the onset of non-fatal myocardial infarction (PCI with OMT (n=4, 8.3%) versus OMT (n=6, 11.3%), respectively, p=0.59); unplanned myocardial revascularization (PCI with OMT (n=1, 2.1%) versus OMT (n=5, 9.4%), respectively, p=0.13). After 12 months, we noted better quality of life results in patients with the addition of the PCI strategy to optimal drug therapy.

Conclusion. PCI in addition to optimal drug therapy in patients with CHF and severe systolic dysfunction does not lead to an improvement in overall and cardiovascular survival, as well as to a decrease in the frequency of non-fatal myocardial infarction within 12 months. There is an improvement in the quality of life of patients with chronic coronary artery disease and CHF with severe left ventricular systolic dysfunction over 12 months of follow-up when performing myocardial revascularization using PCI against the background of OMT.

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About Authors

  • Natal’ya Yu. Sokolova, Dr. Med. Sci.; ORCID
  • Anzor D. Makhauri, Postgraduate; ORCID
  • Sabir R. Medzhidov, Postgraduate; ORCID
  • Ksenia A. Martynova, Postgraduate; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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