Effect of left ventricular hypertrophy on long-term survival of patients with coronary artery disease following percutaneous coronary intervention
Abstract
Overview
The impact of left ventricular hypertrophy
(LVH) on survival among patients with established
coronary artery disease (CAD) is not
well understood. We sought to evaluate the
effect of LVH on the survival of patients with
CAD following percutaneous coronary intervention
(PCI). Three hospitals in New York
City contributed prospectively defined data on
4284 consecutive patients undergoing PCI. Allcause
mortality at a mean follow-up of three
years was the primary endpoint. LVH was present
in 383 patients (8.9%). LVH patients had a
greater prevalence of hypertension (88% vs.
68%, p<0.001), vascular disease (21% vs.
6.6%, p=0.001), and prior heart failure (10%
vs. 5.5%, p<0.001). LVH patients presented
less often with one-vessel disease (38% vs.
50%, p=0.040) and more often with two- (34%
vs. 29%, p=0.014) or three-vessel (22% vs.
18%, p=0.044) disease. Ejection fractions and
angiographic success were similar in both
groups. In-hospital mortality did not differ
between groups. At three-year follow-up, the
survival rate for patients with LVH was 86% vs.
91% in patients without LVH (log-rank
p=0.001). However, after adjustment for differences in baseline characteristics using Cox proportional hazards analysis, LVH was found
not to be an independent predictor of mortality
(hazard ratio, 0.93; 95% confidence interval,
0.68-1.28; p=0.67). We conclude that LVH at
the time of PCI is not independently associated
with an increase in the hazard of death at
three years.
Keywords
Angioplasty, stent, left ventricular hypertrophy, survival.
Article Information
Correspondence
David L. Brown, Division of Cardiovascular Medicine, Stony Brook University Health Sciences Center T 16-080, Stony Brook, NY 11794-8171, USA. E-mail: david.brown@stonybrook. edu
Received
2009-10-17T00:00:00
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