Korean J Intern Med.  2015 Jan;30(1):49-55. 10.3904/kjim.2015.30.1.49.

Clinical impact of routine follow-up coronary angiography after second- or third-generation drug-eluting stent insertion in clinically stable patients

• Choi S
• Mun HS
• Kang MK
• Cho JR
• Han SW
• Lee N

• KMID: 2129663
• DOI: http://doi.org/10.3904/kjim.2015.30.1.49

Abstract

BACKGROUND/AIMS
In the bare-metal stent era, routine follow-up coronary angiography (RFU CAG) was used to ensure stent patency. With the advent of drug-eluting stents (DESs) with better safety and efficacy profiles, RFU CAG has been performed less often. There are few data on the clinical impact of RFU CAG after second- or third-generation DES implantation in clinically stable patients with coronary artery disease; the aim of this study was to examine this issue.
METHODS
We analyzed clinical outcomes retrospectively of 259 patients who were event-free at 12-month after stent implantation and did not undergo RFU CAG (clinical follow-up group) and 364 patients who were event-free prior to RFU CAG (angiographic follow-up group). Baseline characteristics were compared between the groups.
RESULTS
The Kaplan-Meier estimated total survival and major adverse cardiac event (MACE)-free survival did not differ between the groups (p = 0.100 and p = 0.461, respectively). The cumulative MACE rate was also not different between the groups (hazard ratio, 0.85; 95% confidence interval, 0.35 to 2.02). In the angiographic follow-up group, 8.8% revascularization was seen at RFU CAG.
CONCLUSIONS
RFU CAG did not affect long-term clinical outcome after second- or third-generation DES implantation in clinically stable patients.

Keyword

Follow-up; Coronary angiography; Drug-eluting stents

MeSH Terms

Aged
*Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease/radiography/*therapy
Coronary Restenosis/etiology/radiography/surgery
Coronary Vessels/*radiography
Disease Progression
Disease-Free Survival
*Drug-Eluting Stents
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction/etiology/radiography/surgery
Patient Selection
Percutaneous Coronary Intervention/adverse effects/*instrumentation
Predictive Value of Tests
Proportional Hazards Models
Prosthesis Design
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome