Dynamic changes in left ventricular function after a percutaneous coronary intervention: prevalence, predictors, and prognosis.

OBJECTIVES: 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).

CONCLUSION: Changes in LVEF after elective PCI occur often. Both higher baseline LVEF and post-PCI LVEF normalization are associated with improved outcomes.