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Whether change of diastolic function (DF) is associated with long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) is not known. The aim of this study was to investigate prognostic impact of the progression of diastolic dysfunction in patients undergoing PCI.
Consecutive patients who underwent PCI and had echocardiography before and after revascularization were studied. DF was graded as normal, mild (grade 1), moderate (grade 2) or severe (grade 3) dysfunction. Worsening of DF was defined categorically as an aggravation of at least one diastolic functional class at follow-up. The primary outcome was major adverse cardiac events (MACE) defined as a composite of cardiac death, myocardial infarction, and repeat revascularization.
A total of 1235 patients were identified (age, 64.3±11.3 years; 72.1% male). Baseline diastolic dysfunction was present in 1033 patients (83.6%), with mild being the most prevalent (64.6%). Median interval from the baseline to follow-up echocardiography was 7.0 (3.3-11.7) months. During follow-up, DF was worsened in 219 (17.8%) patients, unchanged in 623 patients (50.4%), and 393 (31.8%) had improved or normal DF. The 5-year MACE occurred in 74 patients (42.2%) in the worsening DF group, 107 patients (22.9%) in the unchanged DF group, and 48 patients (14.8%) in the improved or normal DF group. The risk of MACE was significantly higher in the worsened DF group than the unchanged DF (adjusted HR 2.15, 95% CI 1.59–2.90, p<0.001) or improved DF group (adjusted HR 2.20, 95% CI 1.49–3.27, p<0.001).
Aggravation of DF was independently associated with an increased risk of MACE in patients undergoing PCI. Regardless of left ventricular systolic function, to evaluate change of diastolic function after PCI can be a very useful and simple method for predicting long-term clinical outcomes.
IMAGING: Imaging: Non-Invasive