Association Between Revascularization and 30-Day Survival of Ischemic Cardiomyopathy Patients in Dr. Hasan Sadikin General Hospital.

INTRODUCTION

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.

PURPOSE

To evaluate whether revascularization is associated with 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital.

PATIENTS AND METHODS

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.

RESULTS

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).

CONCLUSION

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.