1.Routine Angiographic Follow-Up versus Clinical Follow-Up after Percutaneous Coronary Intervention in Acute Myocardial Infarction.
Yong Hoon KIM ; 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
Yonsei Medical Journal 2017;58(4):720-730
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.
Coronary Angiography
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Drug-Eluting Stents
;
Follow-Up Studies*
;
Humans
;
Incidence
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Logistic Models
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Myocardial Infarction*
;
Percutaneous Coronary Intervention*
;
Propensity Score
Result Analysis
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