Early and late results of percutaneous revascularization in patients with ischemic cardiomyopathy and decreased left ventricular ejection fraction. (Revascularisation in Heart Failure Trial, REHEAT Registry).
OBJECTIVE
REvascularization in Ischaemic HEart Failure Trial (REHEAT) is a registry prospectively evaluating the outcomes of percutaneous myocardial revascularization in postinfarction patients with ischemic cardiomyopathy and various categories of surgical risk.


RESULTS
One hundred seventy consecutive postinfarction patients with LVEF <40% and angiographically documented coronary stenoses eligible for PCI were enrolled to the study. The study end-points included: angiographic success of PCI, major adverse events at 30 days and 1 year after procedure, long-term survival, functional status (CCS and NYHA class) and LVEF 12 months after the intervention. Angiographic success rate was 98,8% and complete revascularization was achieved in 38.8% cases. No periprocedural deaths were registered. Thirtieth-days survival was 97% and was better in comparison to calculated survival for CABG patients; 1-year survival was 94.4% and was not inferior to predicted survival after CABG. In the general study population a significant improvement of LVEF (27,8+/-7,0 to 35,9+/-9,4%) was shown (absolute change mean 6.45+/-10%). In low/intermediate risk group the LVEF increase was lower (6.5+/-10,9) in comparison to high risk group (10,3+/-9,6%)(p=0,042). In both groups a significant and comparable reduction of angina and heart failure severity was shown in 1-year follow-up.


CONCLUSIONS
PCI in postinfarction patients with markedly reduced LVEF is associated with a significant increase of LVEF and favorable clinical outcome (CCS and NYHA class). PCI is safe, feasible and can be an alternative approach to CABG both in low/intermediate and high surgical risk patients.
Buszman
Pawel
P
3rd Division of Cardiology and Acute Coronary Care Unit, Silesian School of Medicine, Katowice, Poland.
Szkróbka
Iwona
I
Tendera
Zofia
Z
Gruszka
Agata
A
Bialkowska
Bozena
B
Parma
Radoslaw
R
Wojakowski
Wojciech
W
Król
Marek
M
Kiesz
Stefan R
SR
Bochenek
Andrzej
A
Tendera
Michal
M