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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. Duygu İnan
Dr. Alper Karakuş
Dr. Sedat Kalkan
Dr. Göksel Çinier
Contributors
Dr. Selin Çakır
Dr. Ezgi Güzel
Dr. Numan Kılıç
Dr. Cansu Öztürk
Dr. Bilal Ülker
Dr. Gözde Yılmaz
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Effect Of Myocardial Viability, Percutaneous Coronary Intervention And Functional Recovery On Clinical Outcomes In The REVIVED-BCIS2 Randomized TrialTürk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - Effect Of Myocardial Viability, Percutaneous Coronary Intervention And Functional Recovery On Clinical Outcomes In The REVIVED-BCIS2 Randomized Trial (Dr. Numan Kılıç)Effect Of Myocardial Viability, Percutaneous Coronary Intervention And Functional Recovery On Clinical Outcomes In The REVIVED-BCIS2 Randomized Trial
Dr. Numan Kılıç
Introduction:
PCI is a frequently used method in the management of patiens with ischemic low EF( EF < % 35) in our country and in the World.Optimal medical treatment has also been observed to have similar outcomes to PCI in selected patients.
Intention:
The goal of the trial was to evaluate percutaneous coronary intervention (PCI) compared with optimal medical thearapy among individuals with left ventricular ejection fraction ( EF < % 35) and extensive coronary artery disease (CAD)
Method:
REVIVED-BSIC2 is a prospective ,multicenter ,open-label, randomized controlled trial.At least 2 years follow-up planned.347 patients with extensive coronary artery disease with EF < % 35 who underwent multiple PCI were compared with 353 patients followed up with OMT.
700 patients were included in the study , an average of 3.4 years of follow –up was provided.Mean age of patients 70 ,percent of women %13 proportion of those with diabetes % 39.
Inclusion criteria :
* LVEF < % 35
* Extensive CAD
* Viability in ≥ 4 dysfunctional myocardial segments
Exclusion criteria:
*Acute myocardial infarction within 4 weeks
* Acute decompaensated heart failture
*Sustained ventricular arrhythemia within 72 hours
Results:
All cause death and hospitalization due to heart failture were observed in % 37.2 of the patients in the PCI group, while it was observed in % 38 of the patients in the OMT group.(primary endpoint p = 0.96) These results were similar in all subgroups.12 month EF change , hospitalization for heart failture acute myocardial infarction rates were similar in both gropus and was no significant.
Left ventricular (LV) recovery by viability characterization:
*All viable myocardium:odds ratio for LV recovery 1.22
*Dysfunctional , but viable myocardium : odds ratio for LV recovery 1.01
*Scar burden : odds ratio for LV recovery 0.69
Outcome:
Multible PCI did not improve overall mortaliy and left ventricular systolic function in low EF patients with extensive coronary artery disease however , there was no signal of harm from this approach.Scar burden , not baseline viability , appears to predict letf ventricular recovery rate.(ACC 2023)CABG is a viable recommendation in very severe coronary artery disease.(The STICH study found an association between positive recovery and increased survival after CABG at long-term follow up, the reason wht these effects were not observed in our study may due to the shorter follow up period , less extensive CAD and fewer patients.
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