Routine Angiographic Follow-Up versus Clinical Follow-Up after Percutaneous Coronary Intervention in Acute Myocardial Infarction.
10.3349/ymj.2017.58.4.720
- Author:
Yong Hoon KIM
1
;
Ae Young HER
;
Seung Woon RHA
;
Byoung Geol CHOI
;
Minsuk SHIM
;
Se Yeon CHOI
;
Jae Kyeong BYUN
;
Hu LI
;
Woohyeun KIM
;
Jun Hyuk KANG
;
Jah Yeon CHOI
;
Eun Jin PARK
;
Sung Hun PARK
;
Sunki LEE
;
Jin Oh NA
;
Cheol Ung CHOI
;
Hong Euy LIM
;
Eung Ju KIM
;
Chang Gyu PARK
;
Hong Seog SEO
;
Dong Joo OH
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
- Publication Type:Original Article
- Keywords:
Acute myocardial infarction;
coronary angiography;
outcomes
- MeSH:
Coronary Angiography;
Drug-Eluting Stents;
Follow-Up Studies*;
Humans;
Incidence;
Logistic Models;
Myocardial Infarction*;
Percutaneous Coronary Intervention*;
Propensity Score
- From:Yonsei Medical Journal
2017;58(4):720-730
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Differences in the utility of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) are not well understood. The present study aimed to compare the 3-year clinical outcomes of RAF and CF in AMI patients who underwent PCI with drug-eluting stents (DES). MATERIALS AND METHODS: A total of 774 consecutive AMI patients who underwent PCI with DES were enrolled. RAF was performed at 6 to 9 months after index PCI (n=425). The remaining patients were medically managed and clinically followed (n=349); symptom-driven events were captured. To adjust for any potential confounders, a propensity score matched analysis was performed using a logistic regression model, and two propensity-matched groups (248 pairs, n=496, C-statistic=0.739) were generated. Cumulative clinical outcomes up to 3 years were compared between RAF and CF groups. RESULTS: During the 3-year follow-up period, the cumulative incidences of revascularization [target lesion revascularization: hazard ratio (HR), 2.40; 95% confidence interval (CI), 1.18–4.85; p=0.015, target vessel revascularization (TVR): HR, 3.33; 95% CI, 1.69–6.58; p=0.001, non-TVR: HR, 5.64; 95% CI, 1.90–16.6; p=0.002] and major adverse cardiac events (MACE; HR, 3.32; 95% CI, 1.92–5.73; p<0.001) were significantly higher in the RAF group than the CF group. However, the 3-year incidences of death and myocardial infarction were not different between the two groups. CONCLUSION: RAF following index PCI with DES in AMI patients was associated with increased incidences of revascularization and MACE. Therefore, CF seems warranted for asymptomatic patients after PCI for AMI.
