Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes
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. We performed...
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| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0168634 |
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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.
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0168634</identifier><identifier>PMID: 28005944</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute coronary syndrome ; Acute Coronary Syndrome - physiopathology ; Acute Coronary Syndrome - surgery ; Acute coronary syndromes ; Aged ; Angina pectoris ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; Care and treatment ; Confidence intervals ; Coronary Artery Bypass ; Coronary vessels ; Electrocardiography ; Female ; Health aspects ; Health risk assessment ; Heart ; Heart attacks ; Heart failure ; Heart surgery ; Hospitals ; Humans ; Left ventricular function ; Male ; Medical prognosis ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Myocardial Revascularization ; Patients ; People and Places ; Prognosis ; Retrospective Studies ; Surgery ; Survival Rate ; Thoracic surgery ; Ventricle ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - surgery</subject><ispartof>PloS one, 2016-12, Vol.11 (12), p.e0168634</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Popovic et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Popovic et al 2016 Popovic et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-b125e47f2e27b54c2460e80a8590224d199b385bd7eff83bfcaf0d37c47420913</citedby><cites>FETCH-LOGICAL-c725t-b125e47f2e27b54c2460e80a8590224d199b385bd7eff83bfcaf0d37c47420913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5179064/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5179064/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28005944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Parolari, Alessandro</contributor><creatorcontrib>Popovic, Batric</creatorcontrib><creatorcontrib>Agrinier, Nelly</creatorcontrib><creatorcontrib>Voilliot, Damien</creatorcontrib><creatorcontrib>Elfarra, Mazen</creatorcontrib><creatorcontrib>Villemot, Jean Pierre</creatorcontrib><creatorcontrib>Maureira, Pablo</creatorcontrib><title>Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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.</description><subject>Acute coronary syndrome</subject><subject>Acute Coronary Syndrome - physiopathology</subject><subject>Acute Coronary Syndrome - surgery</subject><subject>Acute coronary syndromes</subject><subject>Aged</subject><subject>Angina pectoris</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Confidence intervals</subject><subject>Coronary Artery Bypass</subject><subject>Coronary vessels</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Left ventricular function</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Revascularization</subject><subject>Patients</subject><subject>People and Places</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Thoracic surgery</subject><subject>Ventricle</subject><subject>Ventricular Dysfunction, Left - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Popovic, Batric</au><au>Agrinier, Nelly</au><au>Voilliot, Damien</au><au>Elfarra, Mazen</au><au>Villemot, Jean Pierre</au><au>Maureira, Pablo</au><au>Parolari, Alessandro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-12-22</date><risdate>2016</risdate><volume>11</volume><issue>12</issue><spage>e0168634</spage><pages>e0168634-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28005944</pmid><doi>10.1371/journal.pone.0168634</doi><tpages>e0168634</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acute coronary syndrome Acute Coronary Syndrome - physiopathology Acute Coronary Syndrome - surgery Acute coronary syndromes Aged Angina pectoris Cardiology Cardiovascular disease Cardiovascular diseases Care and treatment Confidence intervals Coronary Artery Bypass Coronary vessels Electrocardiography Female Health aspects Health risk assessment Heart Heart attacks Heart failure Heart surgery Hospitals Humans Left ventricular function Male Medical prognosis Medicine and Health Sciences Middle Aged Mortality Myocardial Revascularization Patients People and Places Prognosis Retrospective Studies Surgery Survival Rate Thoracic surgery Ventricle Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - surgery |
| title | Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T10%3A25%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ventricular%20Dysfunction%20in%20Patients%20with%20Acute%20Coronary%20Syndrome%20Undergoing%20Coronary%20Surgical%20Revascularization:%20Prognostic%20Impact%20on%20Long-Term%20Outcomes&rft.jtitle=PloS%20one&rft.au=Popovic,%20Batric&rft.date=2016-12-22&rft.volume=11&rft.issue=12&rft.spage=e0168634&rft.pages=e0168634-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0168634&rft_dat=%3Cgale_plos_%3EA474759836%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1851683395&rft_id=info:pmid/28005944&rft_galeid=A474759836&rft_doaj_id=oai_doaj_org_article_ec87c0251d404db982303afe765718a5&rfr_iscdi=true |