Acute changes in left ventricle end-diastolic pressure in patients undergoing nonprimary percutaneous coronary intervention

Abstract

Background: Percutaneous coronary intervention (PCI) is a critical procedure for managing coronary artery disease (CAD), with nonprimary PCI being increasingly used in elective revascularization. Left ventricular end-diastolic pressure (LVEDP) is an essential marker of ventricular function, often compromised in CAD patients. While its acute changes have been widely studied in primary PCI, research on nonprimary PCI remains limited. This study investigates the acute changes in LVEDP during nonprimary PCI. Materials and Methods: The study was conducted on 100 patients undergoing nonprimary PCI at a tertiary hospital. Baseline LVEDP measurements were taken before the procedure, and post-PCI LVEDP changes were recorded. Patients were categorized based on acute coronary syndrome (ACS) or chronic coronary syndrome (CCS), as well as subcategorized on the type of ACS. Statistical analysis included Mann-Whitney and Kruskal-Wallis tests, with P < 0.05 considered statistically significant. Results: The mean LVEDP decreased by 2.49 mmHg in ACS patients but increased by 0.96 mmHg in CCS patients. ST-segment elevation myocardial infarction (STEMI) patients showed the most significant reduction in LVEDP post-PCI, while non-STEMI (NSTEMI) and unstable angina exhibited smaller decreases. A significant negative correlation was found between LVEDP change and left ventricular ejection fraction. No significant correlation was found between LVEDP change and type and quantity of contrast agent used, number of stents used, serum creatinine level, or coexisting comorbidities such as hypertension and diabetes mellitus. Conclusion: The study highlights that LVEDP decreases more significantly in acute ischemic conditions, such as STEMI, compared to chronic conditions, suggesting that acute myocardial ischemic damage is more reversible with PCI than chronic ischemic damage. The findings indicate that LVEDP is a useful parameter in assessing the success of PCI, particularly in ACS patients, and may help predict procedural outcomes. © 2025 Heart India.