Raharjo Pradana Pratomo, Suhendro Adrian Sebastian, Yahya Achmad Fauzi, Dewi Triwedya Indra
Department of Cardiology and Vascular Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Vasc Health Risk Manag. 2025 Sep 3;21:719-728. doi: 10.2147/VHRM.S524863. eCollection 2025.
Ischemic cardiomyopathy is the leading cause of heart failure and associated with increased morbidity and mortality. The role of percutaneous coronary intervention (PCI) in term of increasing survival and cardiovascular outcomes in ischemic cardiomyopathy remains unclear.
To evaluate whether revascularization is associated with 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital.
This was a single center, observational, retrospective cohort study. Subject data was taken from the CABG and PCI database of Cardiology and Vascular Medicine Department, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital from January 2021 to December 2022. Study outcome was 30-day survival after revascularization procedure. Survival analysis was done using Kaplan-Meier analysis then bivariate analysis with log rank test and cox regression analysis. Cox regression analysis was also done for multivariate analysis of confounding factors.
A total of 67 ischemic cardiomyopathy patients were included in the final analysis of this study with balance proportion except for age, complete revascularization, and chronic total occlusion (CTO) variables. CABG group tends to be younger with more proportion in age ≤65 years old compared with PCI group (92.6% vs. 65%. p = 0.01). Complete revascularization had reached dominantly in the CABG group compared with PCI group (85.2% vs. 15%. p < 0.001). In coronary anatomy characteristic, CTO was found more in the CABG group (81.5% vs. 52.5%. p = 0.02). In 30-day follow up, overall survival rate was 91% with 81.5% in the CABG group compared with 97.5% in the PCI group (p = 0.03). Multivariate analysis was done to exclude confounding factors with adjusted hazard ratio of revascularization was 4.02 (CI95% 0.27-60.3. p = 0.31).
There is no association between revascularization and 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital. However, wide confidence intervals highlight uncertainty.
缺血性心肌病是心力衰竭的主要原因，且与发病率和死亡率的增加相关。经皮冠状动脉介入治疗（PCI）在提高缺血性心肌病患者生存率和改善心血管结局方面的作用仍不明确。
评估在哈山·萨迪金综合医院，血运重建与缺血性心肌病患者30天生存率之间是否存在关联。
这是一项单中心、观察性、回顾性队列研究。研究对象数据取自2021年1月至2022年12月万隆大学医学院 - 哈山·萨迪金综合医院心血管内科和血管医学科的冠状动脉旁路移植术（CABG）和PCI数据库。研究结局为血运重建术后30天生存率。采用Kaplan-Meier分析进行生存分析，然后用对数秩检验和Cox回归分析进行双变量分析。还对混杂因素进行多变量分析的Cox回归分析。
本研究的最终分析共纳入67例缺血性心肌病患者，除年龄、完全血运重建和慢性完全闭塞（CTO）变量外，各比例均衡。与PCI组相比，CABG组年龄往往更年轻，年龄≤65岁的比例更高（92.6%对65%，p = 0.01）。与PCI组相比，CABG组完全血运重建占主导地位（85.2%对15%，p < 0.001）。在冠状动脉解剖特征方面，CABG组中CTO更多见（81.5%对52.5%，p = 0.02）。在30天随访中，总体生存率为91%，CABG组为81.5%，PCI组为97.5%（p = 0.03）。进行多变量分析以排除混杂因素，血运重建的调整后风险比为4.02（95%CI 0.27 - 60.3，p = 0.31）。
在哈山·萨迪金综合医院，缺血性心肌病患者的血运重建与30天生存率之间无关联。然而，较宽的置信区间凸显了不确定性。
