Routine Angiographic Follow-Up versus Clinical Follow-Up after Percutaneous Coronary Intervention in Acute Myocardial Infarction

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 wh...

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Published in:Yonsei medical journal 2017, 58(4), , pp.720-730
Main Authors: Kim, Yong Hoon, Her, Ae Young, Rha, Seung Woon, Choi, Byoung Geol, Shim, Minsuk, Choi, Se Yeon, Byun, Jae Kyeong, Li, Hu, Kim, Woohyeun, Kang, Jun Hyuk, Choi, Jah Yeon, Park, Eun Jin, Park, Sung Hun, Lee, Sunki, Na, Jin Oh, Choi, Cheol Ung, Lim, Hong Euy, Kim, Eung Ju, Park, Chang Gyu, Seo, Hong Seog, Oh, Dong Joo
Format: Article
Language:English
Subjects:
Coronary Angiography
Female
Follow-Up Studies
Humans
Incidence
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - surgery
Original
Percutaneous Coronary Intervention - adverse effects
Propensity Score
Proportional Hazards Models
Treatment Outcome
의학일반
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Summary: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). 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. 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
ISSN:0513-5796
1976-2437
DOI:10.3349/ymj.2017.58.4.720