Single Center Registry For The Value Of Myocardial Revascularization With Percutaneous Coronary Intervention In Coronary Artery Disease Patients With Chronic Heart Failure

Objective To investigate the value of myocardial revascularization with percutaneous coronary intervention in coronary artery disease patients with chronic heart failureMethods Eligible patients with chronic heart failure admitted to department of cardiology, General Hospital of Beijing Military Command, from July 2013 to March 2014, underwent coronary angiography and 72 with multivessel disease (MVD) or proximal left anterior descending disease were included to the study.The baseline SYNTAX score,clinical data, left ventricular ejection fraction (LVEF), NYHA classification,6min walking distance as well as their hospital stay duration and hospitalization expenses were recorded.All-cause death, cardiovascular death, myocardial infarction, stroke and repeat myocardial revascularization, LVEF,NYHA classification,6min walking distance were recorded during six months follow-up by out-patient department visit or telephone. After six months of follow-up, the differences between PCI group and CABG group were studied.Results Parti:After six months of foliow-up,66 patients were included to the study, complete follow-up rate was 91.6%. All-cause death:0 case in either PCI or CABG arms, there were no significant difference between two arms(p> 0.05). Myocardial infarction:lease in PCI arm(2.9%)and 0 case in CABG arm, there were no significant difference between two arms(p> 0.05). Stroke:0 case in PCI arm and 3 cases in CABG arm(9.6%), there were no significant difference between two arms(p> 0.05). Repeat revascularization:6 cases in PCI arm(17.1%) and 0 case in CABG arm, there were significant difference between two arms(p< 0.05).Part II:The average hospital stay duration was 7.11 ±1.68 days for patients in PCI arm and 13.35 ±3.13 days in CABG arm,(p< 0.05). The average hospitalization expenses were 46210 ±18073.91 RMB for patients in PCI arm and 72276 ±7469.70 RMB in CABG arm(p<0.05).PartⅢ:Comparision of heart function indicators pre-and at sixth month in PCI arm were listed as follows:LVEF39.8±5.2% vs 53.9±6.0%, p<0.05; NYHA class 3.1±0.7 vs 1.2±0.4, p<0.05; 6min walking distance 222.5±126.9m vs 514.2±71.1m, p<0.01. Comparision of heart function indicators pre-and at sixth month in CABG arm were listed as follows:LVEF39.45±5.3 vs 54.4±5.65 p<0.01; NYHA class 3.2±0.7 vs 1.3±0.6, p<0.05; 6min walking distance 215.4±125.3 m vs 511.2±78.1, p<0.05.Conclusions 1.This study suggested that PCI, as an alternative way of myocardial reascularization to CABG in multivessel (MVD) or proximal LAD disease patients with chronic heart failure, have simillar safety composite end point of death, myocardial infarction and stroke to CABG Less hospitalization expenses and shorter hospital stay duration were found in PCI arm.2 As an alternative way of myocardial reascularization to CABG in multivessel (MVD) or proximal LAD disease patients with chronic heart failure,PCI can improve left ventricular fuction and exercise tolerance in selected patients.