Prognostic implications of diastolic dysfunction change in patients with coronary artery disease undergoing percutaneous coronary intervention

Eun Kyoung Kim, Joo Yong Hahn, Taek Kyu Park, Joo Myung Lee, Young Bin Song, Sung A. Chang, Sung Ji Park, Seung Hyuk Choi, Sang Chol Lee, Hyeon Cheol Gwon, Jae K. Oh, Seung Woo Park

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1 Scopus citations

Abstract

Background: The association between a change in diastolic function (DF) and long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) is unknown. The aim of this study was to investigate the prognostic effect of changes in diastolic dysfunction in patients undergoing PCI. Methods and Results: Consecutive patients who underwent PCI and echocardiography before and after revascularization were prospectively included. Major adverse cardiac event (MACE) was defined as a composite of cardiac death, myocardial infarction, and repeat revascularization. A total of 1,235 patients were identified. Baseline diastolic dysfunction was present in 1,033 patients (83.6%). At follow-up echocardiography, DF had worsened in 219 (17.8%) patients and was unchanged in 623 patients (50.4%). The risk of MACE was significantly higher in the worsened DF group compared with the unchanged DF group (adjusted hazard ratio [aHR]: 2.15; 95% confidence interval [CI]: 1.59 to 2.90; P<0.001) and the improved or normal DF group (aHR: 2.20; 95% CI, 1.49 to 3.27; P<0.001). Patients with worsened DF consistently had a higher risk of MACE in various subgroups, especially irrespective of left ventricular systolic function. Conclusions: Aggravation of DF was independently associated with an increased risk of MACE in patients undergoing PCI. Evaluating changes in DF after PCI is a simple but useful method for predicting long-term clinical outcomes.

Original languageEnglish (US)
Pages (from-to)1891-1900
Number of pages10
JournalCirculation Journal
Volume83
Issue number9
DOIs
StatePublished - 2019

Keywords

  • Coronary artery disease
  • Diastolic dysfunction
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kim, E. K., Hahn, J. Y., Park, T. K., Lee, J. M., Song, Y. B., Chang, S. A., Park, S. J., Choi, S. H., Lee, S. C., Gwon, H. C., Oh, J. K., & Park, S. W. (2019). Prognostic implications of diastolic dysfunction change in patients with coronary artery disease undergoing percutaneous coronary intervention. Circulation Journal, 83(9), 1891-1900. https://doi.org/10.1253/circj.CJ-19-0237