title: Impact of left ventricular function in relation to procedural outcomes following percutaneous coronary intervention: insights from the British Cardiovascular Intervention Society.
abstract: OBJECTIVE
  Between 10 and 30% of patients undergoing percutaneous coronary intervention (PCI) have left ventricular (LV) dysfunction. We investigate the association between LV function on early and late mortality outcomes in a national 'real-world' cohort undergoing PCI in the elective and acute coronary syndrome setting through analysis of the British Cardiovascular Intervention Society (BCIS) data set.
  
  
  RESULTS
  The relationship between LV function and 30-day mortality in patients undergoing PCI for elective, ST-elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) indications was studied in 230 464 patients in the UK between 2006 and 2011. Abnormal LV function was an independent predictor of 30-day mortality outcomes: 30-day mortality risk for patients with moderate LV function (EF: 30-49%) (HR: 2.91; 95% CI: 2.43-3.49, P < 0.0001) and poor LV function (EF <30%) (HR: 7.25; 95% CI: 5.87-8.96, P < 0.0001) was compared with patients with good LV function (EF >50%). The independent prognostic impact of poor LV function on 30-day mortality increased from elective PCI (HR: 3.72: 95% CI: 2.21-6.25, P < 0.0001) through to the NSTEMI (HR: 5.03: 95% CI: 3.64-6.93, P < 0.0001) and STEMI (HR: 8.18: 95% CI: 5.62-11.92, P < 0.0001).
  
  
  CONCLUSIONS
  Our data suggest a strong relationship between LV function and mortality outcomes following PCI, with worsening LV function independently predicting 30-day and longer-term mortality outcomes across all indications for PCI. We report a differential impact of LV function on mortality outcomes across different indications for PCI, with the greatest adverse prognostic association between worsening LV function and mortality outcomes observed in patients undergoing PCI in the STEMI setting.
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK Cardiovascular Research Group, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK.
authors.forename: Mamas A
authors.initials: MA
authors.lastname: Mamas
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK Cardiovascular Research Group, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK.
authors.forename: Simon G
authors.initials: SG
authors.lastname: Anderson
authors.affiliation: Dorset Heart Centre, Royal Bournemouth Hospital, Bournemouth, UK.
authors.forename: Peter D
authors.initials: PD
authors.lastname: O'Kane
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK Cardiovascular Research Group, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK.
authors.forename: Bernard
authors.initials: B
authors.lastname: Keavney
authors.affiliation: University Hospital of North Staffordshire, Stoke-on-Trent, UK.
authors.forename: James
authors.initials: J
authors.lastname: Nolan
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Oldroyd
authors.affiliation: Cardiovascular Division, Rayne Institute, St Thomas' Hospital Campus, King's College London, London, UK.
authors.forename: Divaka
authors.initials: D
authors.lastname: Perera
authors.affiliation: Cardiovascular Division, Rayne Institute, St Thomas' Hospital Campus, King's College London, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Redwood
authors.affiliation: Freeman Hospital, Newcastle upon Tyne and Institute of Cellular Medicine, Newcastle University UK.
authors.forename: Azfar
authors.initials: A
authors.lastname: Zaman
authors.affiliation: Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Ludman
authors.affiliation: The James Cook University Hospital, Middlesbrough, UK.
authors.forename: Mark A
authors.initials: MA
authors.lastname: de Belder
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000789:Angina, Unstable / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
keywords: Left ventricular function; Outcomes; PCI