Impact of left ventricular ejection fraction and medication adherence on major adverse cardiac events during the first year after successful primary percutaneous coronary interventions

초록

Aims and objectivesTo identify the impact of preprocedural left ventricular ejection fraction and adherence to prescribed medication on major adverse cardiac events in patients with a successful primary percutaneous coronary intervention. BackgroundAlthough advances in percutaneous coronary intervention for coronary artery disease have considerably reduced poor outcomes such as major adverse cardiac events, many patients still experience adverse outcomes after a percutaneous coronary intervention. Thus, in patients with percutaneous coronary intervention, it is extremely important to identify the predictors for major adverse cardiac events. DesignA retrospective and cross-sectional design. MethodsThree hundred and nineteen patients who underwent successful primary percutaneous coronary intervention participated in this study. Participants were assessed for major adverse cardiac events after percutaneous coronary intervention for the first year. Preprocedural left ventricular ejection fraction was measured by echocardiogram. Medication adherence was used with the validated Morisky Medication Adherence Scale-8 items at the first year after the successful primary percutaneous coronary intervention. ResultsOf the 319 patients, 102 had major adverse cardiac events after the successful primary percutaneous coronary intervention. On the basis of Cox regression, after adjusting for patient characteristics, lower baseline left ventricular ejection fraction and medication nonadherence and were statistically significant and independent predictors of major adverse cardiac events. ConclusionsOur results show that major adverse cardiac events after successful primary percutaneous coronary intervention are associated with low left ventricular ejection fraction at baseline and medication nonadherence after discharge. Therefore, healthcare providers should consider multidimensional approaches to improve low left ventricular ejection fraction and medication adherence. Relevance to clinical practiceThe findings suggest that the classification of high-risk patients after percutaneous coronary intervention need to be based on level of preprocedural left ventricular ejection fraction. Follow-up of these patients may include educational interventions to enhance medication adherence, to decrease the prevalence of major adverse cardiac events.

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