Yan-Jie Li1,2, Wei-Wei Zhang1, Xiao-Xiao Yang1, Ning Li1,2, Xing-Biao Qiu1, Xin-Kai Qu1, Wei-Yi Fang1, Yi-Qing Yang1,2,3, Ruo-Gu Li1. 1. Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Cardiovascular Research Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 3. Department of Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
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.
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.
Authors: Erik O Udo; Norbert M van Hemel; Nicolaas P A Zuithoff; Johannes C Kelder; Har A Crommentuijn; Atie M Koopman-Verhagen; Theo Voskuil; Pieter A F M Doevendans; Karel G M Moons Journal: Europace Date: 2011-10-23 Impact factor: 5.214
Authors: Dariush Mozaffarian; Emelia J Benjamin; Alan S Go; Donna K Arnett; Michael J Blaha; Mary Cushman; Sarah de Ferranti; Jean-Pierre Després; Heather J Fullerton; Virginia J Howard; Mark D Huffman; Suzanne E Judd; Brett M Kissela; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Simin Liu; Rachel H Mackey; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Paul Muntner; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Graham Nichol; Latha Palaniappan; Dilip K Pandey; Mathew J Reeves; Carlos J Rodriguez; Paul D Sorlie; Joel Stein; Amytis Towfighi; Tanya N Turan; Salim S Virani; Joshua Z Willey; Daniel Woo; Robert W Yeh; Melanie B Turner Journal: Circulation Date: 2014-12-17 Impact factor: 29.690
Authors: C P Cannon; W S Weintraub; L A Demopoulos; R Vicari; M J Frey; N Lakkis; F J Neumann; D H Robertson; P T DeLucca; P M DiBattiste; C M Gibson; E Braunwald Journal: N Engl J Med Date: 2001-06-21 Impact factor: 91.245
Authors: Hemal Gada; Ajay J Kirtane; Dean J Kereiakes; Sripal Bangalore; Jeffrey W Moses; Philippe Généreux; Roxana Mehran; George D Dangas; Martin B Leon; Gregg W Stone Journal: Am J Cardiol Date: 2015-02-12 Impact factor: 2.778
Authors: Scott D Solomon; Nagesh Anavekar; Hicham Skali; John J V McMurray; Karl Swedberg; Salim Yusuf; Christopher B Granger; Eric L Michelson; Duolao Wang; Stuart Pocock; Marc A Pfeffer Journal: Circulation Date: 2005-12-05 Impact factor: 29.690
Authors: Marina Urena; John G Webb; Corrado Tamburino; Antonio J Muñoz-García; Asim Cheema; Antonio E Dager; Vicenç Serra; Ignacio J Amat-Santos; Marco Barbanti; Sebastiano Immè; Juan H Alonso Briales; Luis Miguel Benitez; Hatim Al Lawati; Angela Maria Cucalon; Bruno García Del Blanco; Javier López; Eric Dumont; Robert Delarochellière; Henrique B Ribeiro; Luis Nombela-Franco; François Philippon; Josep Rodés-Cabau Journal: Circulation Date: 2013-12-26 Impact factor: 29.690
Authors: Gervasio A Lamas; Kerry L Lee; Michael O Sweeney; Russell Silverman; Angel Leon; Raymond Yee; Roger A Marinchak; Greg Flaker; Eleanor Schron; E John Orav; Anne S Hellkamp; Stephen Greer; John McAnulty; Kenneth Ellenbogen; Frederick Ehlert; Roger A Freedman; N A Mark Estes; Arnold Greenspon; Lee Goldman Journal: N Engl J Med Date: 2002-06-13 Impact factor: 91.245