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EVALUATION OF CORONARY AND HEART FAILURE COURSE AND MYOCARDIAL ISCHEMIC DYSFUNCTION REGRESSION AFTER CORONARY STENTING IN PATIENTS WITH LOW EJECTION FRACTION: RESULTS OF 5-YEAR PROSPECTIVE FOLLOW-UP

https://doi.org/10.17802/2306-1278-2012-1-17-25

Abstract

Purpose. To evaluate coronary and heart failure course in patients with ischemic heart disease (IHD) and reduced left ventricular (LV) ejection fraction (EF) within 5 years after coronary stenting. Materials and methods. One hundred and seven patients with IHD and postinfarctLVdysfunction (NYHA II-III), who underwent coronary angioplasty, were examined. All the patients were divided into two groups: Group I included patients (n = 49) with reduced (≤ 45 %) LVEF; Group II consisted of 58 patients with preserved myocardial contractility. Myocardial perfusion, exercise capacity andLVremodeling before and 1, 3 and 5 years after revascularization were assessed. Results. Endovascular revascularization in patients with IHD and reducedLVfunction is highly clinically effective. Successful coronary stenting in patients with reduced LVEF provides a progressive improvement of myocardial contractility within 3 years by increasing EF and reducing end-diastolic pressure by an average of 19 (p = 0,018) and 24 % (p = 0,04) respectively. The use of stents with antiproliferative coating leads to the reduction in the incidence of restenosis by 10,2 % (p = 0,029) 1 year after stenting. However, during the same follow-up period Group I patients had the excess (4-fold) need for repeat myocardial revascularization compared with Group II (p = 0,026). At the same time no signifi cant differences between groups in overall frequency of repeat revascularizations at 3 and 5 years of follow-up have been reported. Conclusions. Coronary stenting in patients with postinfarct heart dysfunction, decreased LVEF (≤ 45 %) and symptoms of II-III NYHA CHF is a highly effective and safe treatment modality. 

About the Authors

A. T. Teplyakov
Research Institute for Сardiology, Tomsk
Russian Federation


E. V. Grakova
Research Institute for Сardiology, Tomsk
Russian Federation


A. L. Krylov
Research Institute for Сardiology, Tomsk
Russian Federation


O. A. Rodionova
Research Institute for Сardiology, Tomsk
Russian Federation


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For citations:


Teplyakov A.T., Grakova E.V., Krylov A.L., Rodionova O.A. EVALUATION OF CORONARY AND HEART FAILURE COURSE AND MYOCARDIAL ISCHEMIC DYSFUNCTION REGRESSION AFTER CORONARY STENTING IN PATIENTS WITH LOW EJECTION FRACTION: RESULTS OF 5-YEAR PROSPECTIVE FOLLOW-UP. Complex Issues of Cardiovascular Diseases. 2012;(1):17-25. (In Russ.) https://doi.org/10.17802/2306-1278-2012-1-17-25

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