Impact of the Completeness of Coronary Revascularization on Quality-of-Life Recovery During Quadruple Therapy in Ischemic Cardiomyopathy
Received: 2026-07-06
Published: 2026-03-30
Abstract
Aim. To determine the extent of quality-of-life (KCCQ-12) recovery over 6 months of treatment in patients with ischemic cardiomyopathy (ICM), its association with the completeness of coronary revascularization, and the independent factors determining this recovery.
Materials and Methods. A total of 168 patients with ICM were included in this prospective single-center study. The Heart Team assigned patients to three groups: Group 1 — complete percutaneous coronary intervention (PCI) (n=58), Group 2 — incomplete PCI (n=54), and Group 3 — optimal medical therapy (OMT) only (n=56); all patients received an SGLT2 inhibitor. Continuous outcomes were analyzed using ANCOVA adjusted for baseline values and residual SYNTAX score, while predictors of response were assessed using logistic regression.
Results. At 6 months, KCCQ-12 scores increased significantly in all groups (Group 1 +14.3; Group 2 +9.5; Group 3 +9.5 points; all within-group p<0.05); 53.7–63.8% of patients achieved a clinically meaningful improvement of ≥5 points. Adjusted between-group differences in KCCQ were not significant (Groups 1 vs 3: +3.28 points; 95% CI −12.8–19.3; p=0.69). Complete revascularization was associated with an additional increase in LVEF (Groups 1 vs 3: +5.01%; 95% CI 1.17–8.84; p=0.01). Change in KCCQ showed a weak but significant correlation with change in LVEF (Spearman r=0.158; p=0.040). The only independent predictor of a ≥10-point response was a lower baseline KCCQ score (OR 0.91 per point; 95% CI 0.88–0.94; p<0.001); completeness of revascularization was not independently associated with the response.
Conclusion. Against the background of SGLT2 inhibitor-based quadruple therapy, quality of life in patients with ICM improved significantly and to a similar extent regardless of the completeness of revascularization, whereas complete revascularization provided additional left ventricular reverse remodeling. The greatest quality-of-life benefit was observed in patients with the most severe symptoms at baseline, supporting personalized, patient-centered decision-making.
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