Left ventricular fractional shortening as a novel predictor of clinical outcomes in patients with coronary artery disease after undergoing PCI: A Retrospective Cohort Study

Background: Even though great advances have been made in the treatment of coronary artery disease (CAD) owing to coronary revascularization and modern antiremodeling therapy, it remains the major cause of cardiac morbidity and mortality worldwide. Risk stratification in CAD patients is primarily based on left ventricular ejection fraction (LVEF), risk scores, and some serum markers. The value of baseline Left ventricular fractional shortening (LVFS) level in predicting the clinical outcomes has not yet been determined. Methods: : In this retrospective cohort study, a total of 3561 patients were enrolled in Clinical Outcomes and Risk Factors of Patients with CAD after percutaneous coronary intervention (PCI), from January 2013 to December 2017. After excluding patients without echocardiography data, we finally enrolled 2787 patients. These patients were divided into two groups according to LVFS value. The lower group (LVFS <31%, n=741), the higher group (LVFS≥31%, n=2046). The average follow-up time were 37.59±22.24 months. Results: : We found that there were significant differences between the two groups in the incidence of all-cause mortality (ACM) ( P <0.001), cardiac mortality (CM) ( P <0.001), major adverse cardiovascular events (MACEs) ( P <0.05) and major adverse cardiovascular and cerebrovascular events (MACCEs) ( P <0.05). Multivariate Cox regression analyses showed that LVFS was an independent predictor for ACM (hazard ratio [HR]:0.473 [95% confidence interval [CI]:0.290-0.772], P =0.003), CM (HR: 0.393 [95% CI:0.213-0.725], P =0.003) in acute coronary syndrome (ACS) patients but that it was an independent predictor for only the incidence of CM (HR: 0.153 [95% CI:0.046-0.504], P =0.002) in stable CAD patients. Conclusion: This study indicates that baseline LVFS is an independent and novel predictor of adverse long-term outcomes in CAD patients who underwent PCI.