open access

Vol 64, No 11 (2006)
Other
Published online: 2006-12-04
Submitted: 2012-12-28
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Original article
Prognostic factors in patients with advanced multi-vessel coronary artery disease

Radosław Kręcki, Jarosław Drożdż, Maria Krzemińska-Pakuła
Kardiol Pol 2006;64(11):1179-1185.

open access

Vol 64, No 11 (2006)
Other
Published online: 2006-12-04
Submitted: 2012-12-28

Abstract


Background: Multivessel coronary artery disease (CAD) not suitable for revascularisation remains a challenge for present cardiology. Due to high mortality and difficulties in pharmacological therapy patients with this particular disease constitute a group of great interest.
Aim: To define the main unfavourable prognostic factors in patients with clinically stable multivessel CAD who do not qualify for percutaneous or surgical revascularisation.
Methods: The analysed group consisted of 106 patients (79 men, 66±8 years) with multi-vessel CAD, confirmed in coronary angiography, who were primarily disqualified from interventional treatment. Thirty-eight (36%) of them had diabetes and 5 (5%) had a previous stroke. The left ventricular ejection fraction was 37±15%, and mean Gensini score – 72±34.
Results: During 7.4±4 years of follow-up, 19 (18%) patients died. Predicting factors of mortality included older age (p=0.014), higher heart rate (p=0.02), diabetes (0.003), renal failure (p=0.0003), heart failure (p=0.013), past stroke (p=0.006) and lower left ventricular ejection fraction (p=0.0012). In multivariate logistic analysis the only significant parameter related to prognosis was decreased level of haemoglobin (p=0.007) and elevated leucocytosis (p=0.002). The ROC curves analysis showed that decreased Hgb (11.3 t/mm3) were significantly associated with higher mortality (HR 6.3).
Conclusions: In patients with multi-vessel CAD not amendable revascularization the haemoglobin level and leucytosis seem to be at least as important as well known risk factors. More intensive complex pharmacotherapy and innovatory cell and gene therapeutic methods may improve the prognosis in this group of patients.

Abstract


Background: Multivessel coronary artery disease (CAD) not suitable for revascularisation remains a challenge for present cardiology. Due to high mortality and difficulties in pharmacological therapy patients with this particular disease constitute a group of great interest.
Aim: To define the main unfavourable prognostic factors in patients with clinically stable multivessel CAD who do not qualify for percutaneous or surgical revascularisation.
Methods: The analysed group consisted of 106 patients (79 men, 66±8 years) with multi-vessel CAD, confirmed in coronary angiography, who were primarily disqualified from interventional treatment. Thirty-eight (36%) of them had diabetes and 5 (5%) had a previous stroke. The left ventricular ejection fraction was 37±15%, and mean Gensini score – 72±34.
Results: During 7.4±4 years of follow-up, 19 (18%) patients died. Predicting factors of mortality included older age (p=0.014), higher heart rate (p=0.02), diabetes (0.003), renal failure (p=0.0003), heart failure (p=0.013), past stroke (p=0.006) and lower left ventricular ejection fraction (p=0.0012). In multivariate logistic analysis the only significant parameter related to prognosis was decreased level of haemoglobin (p=0.007) and elevated leucocytosis (p=0.002). The ROC curves analysis showed that decreased Hgb (11.3 t/mm3) were significantly associated with higher mortality (HR 6.3).
Conclusions: In patients with multi-vessel CAD not amendable revascularization the haemoglobin level and leucytosis seem to be at least as important as well known risk factors. More intensive complex pharmacotherapy and innovatory cell and gene therapeutic methods may improve the prognosis in this group of patients.
Get Citation

Keywords

multivessel coronary artery disease; prognosis

About this article
Title

Original article
Prognostic factors in patients with advanced multi-vessel coronary artery disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 11 (2006)

Pages

1179-1185

Published online

2006-12-04

Bibliographic record

Kardiol Pol 2006;64(11):1179-1185.

Keywords

multivessel coronary artery disease
prognosis

Authors

Radosław Kręcki
Jarosław Drożdż
Maria Krzemińska-Pakuła

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