Open AccessImpact of prior permanent pacemaker on long‐term clinical outcomes of patients undergoing percutaneous coronary intervention
Author(s) -
Li YanJie,
Zhang WeiWei,
Yang XiaoXiao,
Li Ning,
Qiu XingBiao,
Qu XinKai,
Fang WeiYi,
Yang YiQing,
Li RuoGu
Publication year - 2017
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22645
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , cardiology , confidence interval , odds ratio , ejection fraction , heart failure , stroke (engine) , myocardial infarction , coronary artery disease , kidney disease , clinical endpoint , diabetes mellitus , randomized controlled trial , mechanical engineering , engineering , endocrinology
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.