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- Title
Routine Angiographic Follow-Up versus Clinical Follow-Up after Percutaneous Coronary Intervention in Acute Myocardial Infarction.
- Authors
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
- 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.
- Subjects
PERCUTANEOUS coronary intervention; MYOCARDIAL infarction treatment; DRUG-eluting stents; MYOCARDIAL revascularization; ANGIOGRAPHY
- Publication
Yonsei Medical Journal, 2017, Vol 58, Issue 4, p720
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2017.58.4.720