Yang Ming, Guo Fan, Yang Yin-Jian, Jing Zhi-Cheng, Sun Kai
Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730 Beijing, China.
Rev Cardiovasc Med. 2023 Mar 6;24(3):80. doi: 10.31083/j.rcm2403080. eCollection 2023 Mar.
Patients may experience a decline in cardiac function even after successful percutaneous coronary intervention (PCI). It is apparent that the assessment of left ventricular (LV) function before PCI is often overlooked. The purpose of this review is to explore the significance of LV function assessment before PCI by comparing the differences in short- and long-term PCI outcomes between patients with different LV ejection fraction (LVEF) stratified preoperatively.
PubMed and Scopus were searched to identify potential studies from January 1, 2001 through January 1, 2022.
A total of 969,868 participants in 33 studies at different stratifications of baseline LVEF were included in this review and their PCI outcomes were stratified for analysis. The hazard ratio of all-cause mortality within 30 days, one year and greater than 1 year after PCI between patients with abnormal and normal LVEF were 2.96 [95% CI, 2.2, 3.98], 3.14 [95% CI, 1.64, 6.01] and 3.08 [95% CI, 2.6, 3.64]; moderately impaired LV function versus normal were 2.32 [95% CI, 1.85, 2.91], 2.04 [95% CI, 1.37, 3.03], 1.93 [95% CI, 1.54, 2.44]; poor LV function versus normal were 4.84 [95% CI, 3.83, 6.1], 4.48 [95% CI, 1.37, 14.68], 6.59 [95% CI, 4.23, 10.27].
A moderate or severe reduction in patients' LVEF may have a serious impact on PCI prognosis. We strongly advocate for adequate assessment of LVEF before PCI as this will assist in choosing the optimal revascularization and postoperative treatment, thereby reducing short- and long-term mortality.
即使经皮冠状动脉介入治疗（PCI）成功，患者的心功能仍可能下降。显然，PCI术前左心室（LV）功能评估常常被忽视。本综述的目的是通过比较术前分层的不同左心室射血分数（LVEF）患者的短期和长期PCI结局差异，探讨PCI术前LV功能评估的意义。
检索PubMed和Scopus，以识别2001年1月1日至2022年1月1日期间的潜在研究。
本综述纳入了33项研究中不同基线LVEF分层的969,868名参与者，并对其PCI结局进行分层分析。LVEF异常和正常的患者在PCI后30天、1年和超过1年的全因死亡率风险比分别为2.96 [95% CI，2.2，3.98]、3.14 [95% CI，1.64，6.01]和3.08 [95% CI，2.6，3.64]；LV功能中度受损与正常者分别为2.32 [95% CI，1.85，2.91]、2.04 [95% CI，1.37，3.03]、1.93 [95% CI，1.54，2.44]；LV功能差与正常者分别为4.84 [95% CI，3.83，6.1]、4.48 [95% CI，1.37，14.68]、6.59 [95% CI，4.23，10.27]。
患者LVEF中度或重度降低可能对PCI预后产生严重影响。我们强烈主张在PCI术前对LVEF进行充分评估，因为这将有助于选择最佳的血运重建和术后治疗，从而降低短期和长期死亡率。
