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It did not address the relevant clinical issue of revascularization with either procedure of patients with severe LV dysfunction, a population of high risk patients of ten encountered in the every day practice.
In patients with NSTE-ACS, continuing or frequently recurring ischemia, and a contraindication to beta blockers, a nondihydropyridine calcium channel blocker (CCB) (e.g., verapamil or diltiazem) should be given as initial therapy in the absence of clinically significant LV dysfunction, increased risk for cardiogenic shock, PR interval greater than 0.24 second, or second- or third- degree atrioventricular block without a cardiac pacemaker
This study showed that drug-eluting stent implantation in patients with severe LV dysfunction yields similar long term survival benefit when compared with coronary by-pass surgery.
While there is extensive data demonstrating a low TVR in patients with preserved LV function, there are limited reports demonstrating a low TVR in those with poor LV dysfunction.
In selected high risk patients with severe LV dysfunction revascularization with DES implantation offers comparable long term mortality and MACCE rate to CABG patients.
We previously showed that the Z(va)is superior to standard indexes of AS severity in estimating the global hemodynamic load faced by the left ventricle(LV)and predicting the occurrence of LV dysfunction.
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