Preview

Rational Pharmacotherapy in Cardiology

Advanced search

The Short-Term Effect of Stent Size and Number on Left Ventricular Systolic Function Improvement After Elective Percutaneous Coronary Intervention

https://doi.org/10.20996/1819-6446-2020-06-03

Abstract

Background. The effect of stent size and number on left ventricular systolic function improvement after percutaneous coronary intervention (PCI) using drug eluting stent is not clear enough.

Aim. To study short-term effect of stent size and number on left ventricular systolic function improvement after elective PCI.

Material and methods. The study included 150 adult patients with electively stented left anterior descending artery lesion with drug-eluting stent. Patients were examined before PCI and 1 and 3 months after PCI using speckle tracking echocardiography.

Results. Before revascularization, mean left ventricular ejection fraction was 51.2%±5.7, mean global longitudinal peak systolic strain (GLPSS) --9.29±0.94%. One month after PCI, mean GLPSS improved significantly to -14.05±1.72% (p<0.001), 3 months after PCI, even more significant improvement in the GLPSS up to -18.61±3.02% (p<0.001) was recorded. After 3 months, 53 patients (35.3%) showed recovery to normal GLPSS. The predictors of non-improvement of GLPSS after 3 months were: diabetes mellitus (p=0.007), smoking (p=0.01), dyslipidemia (p=0.001), stent length (p=0.001), and a number of stents (p=0.04). There was strong negative correlation between stent length and improvement of the GLPSS in 1 month (p=0.007) and in 3 months (p<0.001). Also there was strong negative correlation between number of stents and improvement in 1 month (p=0.002) and in 3 months (p=0.004), but the correlation between stent diameter and improvement of the GLPSS was significant neither in 1 month nor in 3 months (p=0.924 and p=0.435, respectively).

Conclusion. Number and length of stents implanted were predictors to improvement of systolic function, while stent diameter doesn't affect left ventricular recovery.

About the Authors

Sh. Mostafa
Benha University
Egypt

Shaimaa Mostafa - MD, Assistant Professor, Cardiovascular Department, Faculty of Medicine, Benha University.

Fareed Nada Street, Benha, Qalubiya Governorate, 13511.



O. Sanad
Benha University
Egypt

Osama Sanad - MD, Cardiovascular Department, Faculty of Medicine, Benha University.

Fareed Nada Street, Benha, Qalubiya Governorate, 13511.



M. Shawky
Benha University
Egypt

Mahmoud Shawky - MD, Cardiovascular Department, Faculty of Medicine, Benha University.

Fareed Nada Street, Benha, Qalubiya Governorate, 13511.



M. Magdy
Benha University
Egypt

Mohamed Magdy - MSc, Cardiovascular Department, Faculty of Medicine, Benha University.

Fareed Nada Street, Benha, Qalubiya Governorate, 13511.



E. Elkeshk
Benha University
Egypt

Eman Elkeshk - MD, Cardiovascular Department, Faculty of Medicine, Benha University.

Fareed Nada Street, Benha, Qalubiya Governorate, 13511.



References

1. Celutkiene J., Plymen C.M., Flachskampf FA., et al. Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(12):1615-1633. DOI:10.1002/ejhf.1330.

2. Rihal C.S., Naidu S.S., Givertz M.M., et al. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencionista; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention. J Am Coll Cardiol. 2015;65(19):2140-1. DOI:10.1016/j.jacc.2015.02.043.

3. Adnan Y., Noor L., Dar M.H., et al. Impact of stent length and diameter on Short-term clinical outcomes of drug eluting stents in patients with stable coronary artery disease. Pak J Med Sci. 2017 Jul-Aug;33(4):959-962. DOI:10.12669/pjms.334.13068.

4. Lang R.M., Badano L.P., Mor-Avi V., et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. DOI:10.1016/j.echo.2014.10.003.

5. De Benedetti E., Urban P. Coronary stenting: why size matters. Heart. 2007;93(12):1500-1. DOI: 10.1136/hrt.2006.113860

6. Cameli M., Mondillo S., Galderisi M., et al. Speckle tracking echocardiography: a practical guide. G Ital Cardiol (Rome). 2017 Apr;18(4):253-269. DOI: 10.1714/2683.27469.

7. Magdy G., Sadaka M., Elzawawy T., Elmaghraby A. Effect of elective percutaneous coronary intervention of left anterior descending coronary artery on regional myocardial function using strain imaging. Egypt Heart J. 2018;70(2):83-88. DOI:10.1016/j.ehj.2017.12.003.

8. Geyer H., Caracciolo G., Abe H., et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010;23(4):351-69. DOI:10.1016/j.echo.2010.02.015.

9. Sandeep, Patted S.V., Halkatti P., Modi R. Effect of Stent Length on Clinical Outcome in Patients with Coronary Artery Disease. Indian Journal of Science and Technology. 2015; 8(4):329-36.

10. Agirbasli M., Guler N. Recovery of left ventricular systolic function after left anterior descending coronary artery stenting. J Interv Cardiol. 2005;18(2):83-8. DOI:10.1111/j.1540-8183.2005.00382.x


Review

For citations:


Mostafa Sh., Sanad O., Shawky M., Magdy M., Elkeshk E. The Short-Term Effect of Stent Size and Number on Left Ventricular Systolic Function Improvement After Elective Percutaneous Coronary Intervention. Rational Pharmacotherapy in Cardiology. 2020;16(3):342-347. https://doi.org/10.20996/1819-6446-2020-06-03

Views: 551


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)