Abstract 19028: Revascularization in Ischemic Cardiomyopathy With Left Ventricular Systolic Dysfunction- Percutaneous Intervention (PCI) vs Medical Therapy

Abstract

Background: The benefits of percutaneous revascularization in patients with reduced Left Ventricular (LV) systolic function secondary to stable coronary artery disease (CAD) is still ambiguous. We aim to compare the survival benefits of PCI in patients with Ischemic cardiomyopathy with reduced LV Ejection Fraction (LVEF <35%) compared to Medical Therapy (MT) alone. Methods: A systematic search was conducted in PubMed, Google Scholar, and Cochrane databases from inception to 5 th June 2023. Among 108 results from the systematic search, a total of 4 studies (2080 patients) were included. Our outcome of interest was all-cause mortality in patients undergoing PCI vs. medical therapy. We used random-effects models to aggregate data and to calculate pooled incidence and relative risk (RR) with 95% confidence intervals (CIs). Results: Of 1082 patients undergoing revascularization with PCI and 998 patients in the medical therapy arm, the outcome of all-cause mortality occurred in 168 patients (15.5%) in the PCI group and in 200 patients (20.0%) in the medical therapy group (Hazard ratio, 0.88; 95% confidence interval [CI], 0.71 to 1.09; P=0.25). However, a non-statistical trend toward lower mortality was noted in the PCI arm. Low heterogenicity was noted between the studies. Conclusions: In patients with ischemic cardiomyopathy with reduced LV systolic function (EF <35%), revascularization with PCI is associated with similar all-cause mortality compared to medical therapy.