Impact of prior permanent pacemaker on long‐term clinical outcomes of patients undergoing percutaneous coronary intervention. Issue 4 (23rd November 2016)

• Record Type: Journal Article
• Authors: Li, Yan‐Jie; Zhang, Wei‐Wei; Yang, Xiao‐Xiao; Li, Ning; Qiu, Xing‐Biao; Qu, Xin‐Kai; Fang, Wei‐Yi; Yang, Yi‐Qing; Li, Ruo‐Gu
• Is Part Of: Clinical cardiology. Volume 40:Issue 4(2017)
• Page Start: 205
• Page End: 209
• Publication Date: 2016-11-23
• Subjects: percutaneous conronary intervention -- pacemaker -- prognosis -- heart failure; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22645
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : Background: The impact of permanent pacemaker (PPM) on long‐term clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) has not been studied. Hypothesis: PPM may increase heart failure (HF) burden on patients undergoing PCI. Methods: We recruited consecutive patients undergoing PCI and carried out a nested case–control study. Patients with confirmed PPM undergoing first PCI were identified and matched by age and sex in 1:1 fashion to patients without PPM undergoing first PCI. Clinical data were collected and analyzed. The primary endpoint outcomes were all‐cause mortality and hospitalization for HF. Results: The final analysis included 156 patients. The mean follow‐up period was 4.6 ± 2.9 years. The overall all‐cause mortality was 21.15%, without significant difference between the 2 groups (21.79% vs 20.51%; P = 0.85). However, the rate of HF‐related hospitalization was significantly higher in patients with PPM than in controls (26.92% vs 10.26%; P = 0.008). After adjustment for hypertension, type 2 diabetes mellitus, hyperlipidemia, chronic kidney disease, stroke, left ventricular ejection fraction, brain natriuretic peptide, and acute coronary syndrome (ACS), PCI patients with PPM were still associated with a greater hospitalization rate for HF (odds ratio: 4.31, 95% confidence interval: 0.94‐19.80, P = 0.061). Further analysis in the ACS subgroup showed VVI‐mode pacing enhanced the risk for HF‐associated hospitalization (adjusted odds ratio: 8.27, 95% confidence interval: 1.37‐49.75, P = 0.02). Conclusions: PPM has no effect on all‐cause mortality in patients undergoing first PCI but significantly increases the HF‐associated hospitalization rate, especially in ACS patients.