[Türkçe]

Turkish Society of Cardiology Young Cardiologists Bulletin Year: 5 Number: 6 / 2022


Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin

Coordinator for the
Board of Directors

Dr. Ertuğrul Okuyan

Coordinator for the
Board of Directors

Dr. Can Yücel Karabay

Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı

Bulletin Editors
Dr. Muzaffer Değertekin
Dr. Bülent Mutlu
Dr. Süleyman Çağan Efe
Dr. Göksel Çinier
Dr. Duygu İnan
Dr. Sedat Kalkan

Contributors
Dr. Onur Akhan
Dr. Fatih Aksoy
Dr. Derya Baykiz
Dr.  İlyas Çetin
Dr. Uğur Ozan Demirhan
Dr. Elif Ayduk Gövdeli
Dr. Mustafa Ferhat Keten
Dr. Bengisu Keskin Meriç
Dr. İbrahim Halil Özdemir
Dr. Mehmet Arslan
Dr. Hüseyin Durak
Dr. Levent Pay


 



6--14

Revascularisation for ischemic ventricular dysfunction: REVIVED trialTürk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - Revascularisation for ischemic ventricular dysfunction: REVIVED trial (Dr. Elif Ayduk Gövdeli)

Reviewer: : Dr Elif Ayduk Gövdeli

Name of the Study: Revascularisation for ischemic ventricular dysfunction: REVIVED trial

Published Congress: ESC 2022

Link : https://www.escardio.org/The-ESC/Press-Office/Press-releases/Coronary-stenting-does-not-benefit-patients-with-severe-left-ventricular-dysfunction

Background:

Coronary artery disease is the most common cause of heart failure; associated with lower survival and quality of life. Revascularization to improve blood flow is a long-considered treatment option. Percutaneous coronary intervention (PCI) is an attractive alternative to bypass surgery without early adverse outcomes. However, there is no randomized evidence to support the efficacy and safety of PCI in these patients.

Objective:

The aim of this study is to investigate the efficacy and safety of PCI in patients with severe left ventricular dysfunction.

Methods:

Patients with severe left ventricular systolic dysfunction (ejection fraction 35% or less), extensive coronary artery disease, and patients with at least four viable dysfunctional myocardial segments that could be revascularized by PCI were enrolled.

Patients with myocardial infarction in the last four weeks, decompensated heart failure, and sustained ventricular arrhythmias within the last 72 hours were excluded.

A total of 700 patients at 40 centres in the UK were randomised 1:1 to the optimal medical treatment with PCI or the optimal medical treatment alone.

The primary outcome is death from all causes or hospitalization for heart failure. The secondary outcome was determined as left ventricular ejection fraction and quality of life measures at 6 and 12 months.

Results:

The median age of the participants was 70 and 88% were male. The mean left ventricular ejection fraction was 28%. During a median follow-up of 3.4 years, the primary outcome was seen in 129 (37.2%) patients in the PCI group and 134 (38%) in the medical treatment group alone. The hazard ratio was determined as 0.99 (95% Confidence interval 0.78-1.27, p-value 0.96). There was no significant difference between the two groups in left ventricular ejection fraction measurements at 6 and 12 months. Although the 6th and 12th month quality of life data were in favour of the PCI group, no significant difference was observed between the two groups in the 24th month.

Conclusion:

PCI does not reduce all-cause mortality or hospitalization for heart failure in patients with severe left ventricular dysfunction and extensive coronary artery disease.

Interpretations:

PCI should not be recommended in stable patients with ischemic left ventricular systolic dysfunction, where our sole aim is prognostic benefit. However, it should be noted that this study excluded patients with restrictive angina or recent acute coronary syndrome for whom PCI is still an option.


6--14

 2025 © Turkish Society of Cardiology.