title: Dynamic changes in left ventricular function after a percutaneous coronary intervention: prevalence, predictors, and prognosis.
abstract: OBJECTIVE
  To estimate the prevalence, identify predictors, and assess the prognostic implications of left ventricular ejection fraction (LVEF) changes after an elective percutaneous coronary intervention (PCI).
  
  
  METHODS
  We included all consecutive patients who underwent elective PCI in our institution and were evaluated with echocardiography before and within 1 year of the procedure. Patients were grouped in terms of baseline LVEF. Hazard ratios (HRs) for all-cause mortality and acute myocardial infarction were calculated for baseline LVEF groups and in terms of LVEF normalization or decline.
  
  
  RESULTS
  A total of 974 patients were included. Patients with moderately impaired (HR 1.41, P=0.01) and poor LVEF (HR 2.44, P<0.001) had significantly worse survival in comparison with patients with good LVEF. Decline from preserved to impaired LVEF following PCI was associated with an increased 1-year risk (HR 3.48, P<0.001) and 5-year risk (HR 2.79, P<0.001) for the composite outcome of all-cause mortality and acute myocardial infarction. LVEF recovery from impaired to preserved was associated with a decreased 5-year risk for the composite outcome (HR 0.5, P<0.001).
  
  
  CONCLUSIONS
  Changes in LVEF after elective PCI occur often. Both higher baseline LVEF and post-PCI LVEF normalization are associated with improved outcomes.
authors: aDepartment of Cardiology, Rabin Medical Center, Petach-Tikva bSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Amos
authors: A
authors: Levi
authors: Tamir
authors: T
authors: Bental
authors: Abid R
authors: AR
authors: Assali
authors: Eli I
authors: EI
authors: Lev
authors: Hana
authors: H
authors: Vaknin Assa
authors: Aviv A
authors: AA
authors: Shaul
authors: Alexander
authors: A
authors: Sagie
authors: Ran
authors: R
authors: Kornowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D016277:Ventricular Function, Left