title: Impact of depressed left ventricular function on outcomes in patients with three-vessel coronary disease undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  Patients with multivessel coronary artery disease and depressed left ventricular ejection fraction (LVEF) represent a high risk group of patients for coronary revascularization. There are limited data on percutaneous coronary intervention treatment in this population.
  
  
  METHODS
  Among a cohort of 4335 patients with three-vessel disease with or without left main disease undergoing percutaneous coronary intervention, 191 patients had LVEF < 40% (low ejection fraction (EF)) and 4144 patients had LVEF ≥ 40%. In-hospital and long-term outcomes were examined according to LVEF.
  
  
  RESULTS
  The estimated two-year rates of major adverse cardiac events, cardiac death, and myocardial infarction were significantly higher in the low EF group (19.64% vs. 8.73%, Log-rank test: P < 0.01; 10.30% vs. 1.33%, Log-rank test: P < 0.01, and 10.32% vs. 2.28%, Log-rank test: P < 0.01 respectively), but there was no difference in the rates of target vessel revascularization (6.18% vs. 6.11%, Log-rank test: P = 0.96). Using the Cox proportional hazard models, LVEF < 40% was a significant risk factor for cardiac death, myocardial infarction, and major adverse cardiac events (OR (95%CI): 4.779 (2.369 - 9.637), 2.673 (1.353 - 5.282), and 1.827 (1.187 - 2.813) respectively), but was not a statistically significant risk factor for target vessel revascularization (OR (95%CI): 1.094 (0.558 - 2.147)).
  
  
  CONCLUSIONS
  Among patients undergoing percutaneous coronary intervention for multivessel coronary artery disease, left ventricular dysfunction remains associated with further risk of cardiac death in-hospital and during long-term follow-up.
authors: Cardiovascular Institute & Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
authors: Zhan
authors: Z
authors: Gao
authors: Bo
authors: B
authors: Xu
authors: Ajay J
authors: AJ
authors: Kirtane
authors: Yue-jin
authors: YJ
authors: Yang
authors: Jin-qing
authors: JQ
authors: Yuan
authors: Ji-lin
authors: JL
authors: Chen
authors: Shu-bin
authors: SB
authors: Qiao
authors: Yong-jian
authors: YJ
authors: Wu
authors: Xue-wen
authors: XW
authors: Qin
authors: Hong-bin
authors: HB
authors: Yan
authors: Min
authors: M
authors: Yao
authors: Hai-bo
authors: HB
authors: Liu
authors: Jue
authors: J
authors: Chen
authors: Shi-jie
authors: SJ
authors: You
authors: Run-lin
authors: RL
authors: Gao
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology*