Medical treatment of patients with heart failure or left ventricular dysfunction undergoing percutaneous coronary intervention.
Management of ischemic patients with pre-existing or new-onset left ventricular (LV) dysfunction poses a special challenge in terms of the timing of percutaneous coronary intervention (PCI) and appropriate adjunctive medications to optimize outcome while minimizing risk. In a systematic fashion, this review attempts to provide a management scheme for patients with heart failure or LV dysfunction that present with stable angina, ST-segment elevation myocardial infarction, or unstable angina/non-ST-segment elevation myocardial infarction. By addressing therapeutic approaches to acute or decompensated heart failure and timing of coronary angiography based on severity of ischemia, we provide evidence-based recommendations for medications to initiate before, during, and following PCI.
Lipinski
Michael J
MJ
Division of Cardiology, Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, Virginia, USA.
Vetrovec
George W
GW
D000787:Angina Pectoris / Q000503:physiopathology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D004358:Drug Therapy / Q000379:methods*; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy*