title: Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes.
abstract: BACKGROUND
  Patients with non-ST elevation acute coronary syndrome complicated by left ventricular dysfunction (LVEF) are a poor prognosis group. The aim of our study was to assess the short and long term LEVF prognostic value in a cohort of NSTE-ACS patients undergoing surgical revascularization.
  
  
  METHODS
  We performed elective and isolated CABG on a cohort of 206 consecutive patients with LVEF≤0.40 complicating acute coronary syndrome. The case cohort was compared with a cohort of controls (LVEF>0.40) randomly selected (2:1) among patients who underwent the procedure during this period.
  
  
  RESULTS
  The Kaplan-Meier 5-year estimated survival rates for patients in the low and normal LVEF groups were 70.8% (95% confidence interval CI: 64.2-77.4) and 81.7% (95%CI: 77.8-85.6), respectively. A low LVEF was associated with both a higher all-cause (HR [95%CI] = 1.84[1.18-2.86]) and a higher cardiovascular mortality (HR = 2.07 [1.27-3.38]) during the first 12 months of follow-up. After adjustment for potential confounders, a low LVEF remained associated with a higher cardiovascular mortality only (1.87[1.03-3.38]) during the first 12 months of follow-up. After 12 months of follow-up, a low LVEF was no more associated with all-cause, nor cardiovascular mortality.
  
  
  CONCLUSIONS
  Patients with low LVEF might require more intensive care than patients with normal LVEF during the year after the surgical procedure, but once the first postoperative year over, the initial low LVEF was no more associated with long term mortality.
authors.affiliation: CHU Nancy, Département de Cardiologie, Nancy, France.
authors.forename: Batric
authors.initials: B
authors.lastname: Popovic
authors.affiliation: CHU Nancy, Epidémiologie et Evaluation Cliniques, Nancy, France.
authors.forename: Nelly
authors.initials: N
authors.lastname: Agrinier
authors.affiliation: CHU Nancy, Département de Cardiologie, Nancy, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Voilliot
authors.affiliation: CHU Nancy, Service de chirurgie des maladies cardiovasculaires et transplantations, Nancy, France.
authors.forename: Mazen
authors.initials: M
authors.lastname: Elfarra
authors.affiliation: CHU Nancy, Service de chirurgie des maladies cardiovasculaires et transplantations, Nancy, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Villemot
authors.affiliation: CHU Nancy, Service de chirurgie des maladies cardiovasculaires et transplantations, Nancy, France.
authors.forename: Pablo
authors.initials: P
authors.lastname: Maureira
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery*