Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share By
Decision Making in Ischemic Cardiomyopathy: Variability in Physicians' Approaches and Patients' Adherence



Bahremand M1 ; Ahmadinejad T2 ; Jenab Y2 ; Hoseini SK3 ; Lotfitokaldany M4 ; Jalali A5
Authors

Source: Revista Latinoamericana de Hipertension Published:2019

Abstract

schemic cardiomyopathy (ICM) is a common cardiovascular disease with conflicting evidence regarding its management and a high risk profile for revascularization procedures that seems to have resulted in variable approach of physicians toward its management, and likewise, significant patient non-adherence to physician recommendation. We included patients with 3-vessel disease and left ventricular ejection fraction (LVEF) <45%(ICM group; n=825), and patients with LM disease and LVEF ≥45% (LM group; n=162), detected by coronary angiography at Tehran Heart Center. Variation of recommendations among cardiologists was evaluated. The rate of coronary artery bypass graft (CABG) non-adherence was also determined, as well as its predictors and outcome in ICM group. Decision making was more variable in ICM group, compared to LM group. CABG non-adherence was significantly more common in ICM group (32.4%), compared to LM group (10.0%) (P<0.001). Advanced age, being female, absence of angina, creatinine >2mg/dl, severe left ventricular dysfunction, absence of LM disease and moderate or severe mitral regurgitation were predictors of CABG non-adherence. ICM patients with CABG non-adherence had significantly more all-cause mortality (Hazard Ratio [HR]: 1.97, 95% confidence interval [CI]: 1.28-3.04), and more all-cause mortality, revascularization or hospitalization due to cardiac disease (HR: 1.94, 95% CI: 1.41-2.67), than those who received CABG. While ICM is a common disorder encountered frequently in daily practice of cardiologists, there is a significant variability in decision making, as well as a significant non-adherenceto lifesaving recommendations for these patients. © 2019 Revista Latinoamericana de Hipertension. All rights reserved.
Other Related Docs