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 SeoDong Joo Oh

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)720-730
Number of pages11
JournalYonsei Medical Journal
Volume58
Issue number4
DOIs
Publication statusPublished - 2017 Jul 1

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Percutaneous Coronary Intervention
Myocardial Infarction
Drug-Eluting Stents
Confidence Intervals
Incidence
Logistic Models
Propensity Score
Research Design

Keywords

  • Acute myocardial infarction
  • Coronary angiography
  • Outcomes

ASJC Scopus subject areas

  • Medicine(all)

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Routine angiographic follow-up versus clinical follow-up after percutaneous coronary intervention in acute myocardial infarction. / 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.

In: Yonsei Medical Journal, Vol. 58, No. 4, 01.07.2017, p. 720-730.

Research output: Contribution to journalArticle

Kim, YH, Her, AY, Rha, S-W, Choi, BG, Shim, M, Choi, SY, Byun, JK, Li, H, Kim, W, Kang, JH, Choi, JY, Park, EJ, Park, SH, Lee, S, Na, JO, Choi, CU, Lim, HE, Kim, EJ, Park, CG, Seo, HS & Oh, DJ 2017, 'Routine angiographic follow-up versus clinical follow-up after percutaneous coronary intervention in acute myocardial infarction', Yonsei Medical Journal, vol. 58, no. 4, pp. 720-730. https://doi.org/10.3349/ymj.2017.58.4.720
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. / Routine angiographic follow-up versus clinical follow-up after percutaneous coronary intervention in acute myocardial infarction. In: Yonsei Medical Journal. 2017 ; Vol. 58, No. 4. pp. 720-730.
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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.",
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T1 - Routine angiographic follow-up versus clinical follow-up after percutaneous coronary intervention in acute myocardial infarction

AU - Kim, Yong Hoon

AU - Her, Ae Young

AU - Rha, Seung-Woon

AU - Choi, Byoung Geol

AU - Shim, Minsuk

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Li, Hu

AU - Kim, Woohyeun

AU - Kang, Jun Hyuk

AU - Choi, Jah Yeon

AU - Park, Eun Jin

AU - Park, Sung Hun

AU - Lee, Sunki

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

PY - 2017/7/1

Y1 - 2017/7/1

N2 - 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.

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KW - Acute myocardial infarction

KW - Coronary angiography

KW - Outcomes

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