1. Long-term analysis of left ventricular ejection fraction in patients with stable multivessel coronary disease undergoing medicine, angioplasty or surgery: 10-year follow-up of the MASS II trial
- Author
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José Antonio Franchini Ramires, Whady Hueb, Ricardo D'Oliveira Vieira, Alexandre Ciappina Hueb, Desiderio Favarato, Paulo R. Soares, Eduardo Gomes Lima, Alexandre C. Pereira, Carlos Vicente Serrano, Paulo Cury Rezende, Roberto Kalil Filho, Cibele Larrosa Garzillo, and Bernard J. Gersh
- Subjects
Male ,medicine.medical_specialty ,VENTRÍCULO CARDÍACO ,medicine.medical_treatment ,Myocardial Infarction ,Coronary artery disease ,Coronary artery bypass surgery ,Ventricular Dysfunction, Left ,Percutaneous Coronary Intervention ,Internal medicine ,Angioplasty ,medicine ,Myocardial Revascularization ,Humans ,cardiovascular diseases ,Myocardial infarction ,Coronary Artery Bypass ,Aged ,Analysis of Variance ,Ejection fraction ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,Cardiovascular Agents ,Stroke Volume ,Middle Aged ,medicine.disease ,Surgery ,Stroke ,Treatment Outcome ,Echocardiography ,Cardiovascular agent ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background Assuming that coronary interventions, both coronary bypass surgery (CABG) and percutaneous coronary intervention (PCI), are directed to preserve left ventricular function, it is not known whether medical therapy alone (MT) can achieve this protection. Thus, we evaluated the evolution of LV ejection fraction (LVEF) in patients with stable coronary artery disease (CAD) treated by CABG, PCI, or MT as a post hoc analysis of a randomized controlled trial with a follow-up of 10 years. Methods Left ventricle ejection fraction was assessed with transthoracic echocardiography in patients with multivessel CAD, participants of the MASS II trial before randomization to CABG, PCI, or MT, and re-evaluated after 10 years of follow-up. Results Of the 611 patients, 422 were alive after 10.32 ± 1.43 years. Three hundred and fifty had LVEF reassessed: 108 patients from MT, 111 from CABG, and 131 from PCI. There was no difference in LVEF at the beginning (0.61 ± 0.07, 0.61 ± 0.08, 0.61 ± 0.09, respectively, for PCI, CABG, and MT, P = 0.675) or at the end of follow-up (0.56 ± 0.11, 0.55 ± 0.11, 0.55 ± 0.12, P = 0.675), or in the decline of LVEF (reduction delta of −7.2 ± 17.13, −9.08 ± 18.77, and −7.54 ± 22.74). Acute myocardial infarction (AMI) during the follow-up was associated with greater reduction in LVEF. The presence of previous AMI (OR: 2.50, 95% CI: 1.40–4.45; P = 0.0007) and during the follow-up (OR: 2.73, 95% CI: 1.25–5.92; P = 0.005) was associated with development of LVEF
- Published
- 2013