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Objective To explore the relationship between reduced left ventricular ejection fraction(LVEF) and characteristics of coronary artery disease(CAD) and investigate the association between reduced LVEF and cardiovascular prognosis.Design and method A total of 677 hospitalized patients with angiographic CAD were enrolled.All patients clinical data, LVEF were measured, other variables including high sensitive C reactive protein(hs-CRP), white blood cells (WBC) and classic cardiovascular risk factors and so on, were recorded after admission.The primary end point was combination occurrence of major adverse cardiovascular and cerebral events(MACCE), including death, targeted vascular revascularization, non-fatal myocardial infarction and rehospitalization due to unstable angina, rehospitalization due to heart failure, transient ischemic attack and stroke.Results All patients were divided into a normal LVEF group, reduced LVEF group.Compared with normal LVEF group, reduced LVEF group had more severe coronary stenosis(62.85±41.45 vs 47.54±33.33), a higher level of WBC and hs-CRP and more smokers[WBC(×109/L): 7.60±2.71 vs 7.09±2.14, hs-CRP(mg/L): 5.68±3.97 vs 4.00±3.76, P< 0.05].All patients were tracked for 15±12 months.A total of 146 MACCE occurred during following up.The incidence of MACCE was significantly increased in the reduced LVEF group (0.576±0.113 vs 0.603±0.101).In univariate and multivariate Cox regression analysis reduced LVEF is an independent predictors of MACCE in patients with CAD [RR=0.974, 95%CI (0.960,0.988), P=0.000] and [RR=0.98, 95%CI (0.963,0.998), P=0.025].Kaplan-Meier survival analysis suggested that patients with reduced LVEF had a decreased event free survival ratio(log-rank x2 =14.56, p=0.025).Conclusion LVEF level is associated with coronary artery severity, inflammatory factors and independently predict the prognosis of coronary artery disease.