Routine angiographic follow-up versus clinical follow-up in patients with diabetes following percutaneous coronary intervention with drug-eluting stents in Korean population

Yong Hoon Kim, Ae Young Her, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Yoonjee Park, Man Jong Baek, Yang Gi Ryu, Ahmed Mashaly, Won Young Jang, Woohyeun Kim, Eun Jin Park, Jah Yeon Choi, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Seung-Woon Rha

Research output: Contribution to journalArticle

Abstract

Aims: The usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in patients with diabetes is not well understood. We compare 3-year clinical outcomes of RAF and CF in diabetic patients underwent PCI with drug-eluting stents (DES). Methods: A total of 843 patients with diabetes who underwent PCI with DES were enrolled. RAF was performed at 6–9 months after PCI (n = 426). Rest of patients were medically managed and clinically followed (n = 417); symptom-driven events were captured. After propensity score matched analysis, 2 propensity-matched groups (262 pairs, n = 524, C-statistic = 0.750) were generated. The primary endpoint was major adverse cardiac events (MACE), the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR). Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization [TLR: hazard ratio (HR), 4.07; 95% confidence interval (CI), 1.18–9.34; p = 0.001], target vessel revascularization (TVR: HR, 4.02; 95% CI, 1.93–8.40; p < 0.001), non-TVR (HR, 4.92; 95% CI, 1.68–14.4; p = 0.004) and major adverse cardiac events (MACE: HR, 2.53; 95% CI, 1.60–4.01, p < 0.001) were significantly higher in the RAF group. However, the incidence of total death, non-fatal MI were similar between the two groups. Conclusions: RAF following index PCI with DES in patients with diabetes was associated with increased incidence of revascularization and MACE without changes of death or re-infarction rates and increased TLR and TVR rates in both first- and second-generation DES.

Original languageEnglish
Pages (from-to)138-148
Number of pages11
JournalDiabetes Research and Clinical Practice
Volume138
DOIs
Publication statusPublished - 2018 Apr 1

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

Keywords

  • Clinical follow-up
  • Diabetes
  • Drug-eluting stent
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Routine angiographic follow-up versus clinical follow-up in patients with diabetes following percutaneous coronary intervention with drug-eluting stents in Korean population. / Kim, Yong Hoon; Her, Ae Young; Choi, Byoung Geol; Choi, Se Yeon; Byun, Jae Kyeong; Park, Yoonjee; Baek, Man Jong; Ryu, Yang Gi; Mashaly, Ahmed; Jang, Won Young; Kim, Woohyeun; Park, Eun Jin; Choi, Jah Yeon; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Rha, Seung-Woon.

In: Diabetes Research and Clinical Practice, Vol. 138, 01.04.2018, p. 138-148.

Research output: Contribution to journalArticle

Kim, Yong Hoon ; Her, Ae Young ; Choi, Byoung Geol ; Choi, Se Yeon ; Byun, Jae Kyeong ; Park, Yoonjee ; Baek, Man Jong ; Ryu, Yang Gi ; Mashaly, Ahmed ; Jang, Won Young ; Kim, Woohyeun ; Park, Eun Jin ; Choi, Jah Yeon ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Rha, Seung-Woon. / Routine angiographic follow-up versus clinical follow-up in patients with diabetes following percutaneous coronary intervention with drug-eluting stents in Korean population. In: Diabetes Research and Clinical Practice. 2018 ; Vol. 138. pp. 138-148.
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abstract = "Aims: The usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in patients with diabetes is not well understood. We compare 3-year clinical outcomes of RAF and CF in diabetic patients underwent PCI with drug-eluting stents (DES). Methods: A total of 843 patients with diabetes who underwent PCI with DES were enrolled. RAF was performed at 6–9 months after PCI (n = 426). Rest of patients were medically managed and clinically followed (n = 417); symptom-driven events were captured. After propensity score matched analysis, 2 propensity-matched groups (262 pairs, n = 524, C-statistic = 0.750) were generated. The primary endpoint was major adverse cardiac events (MACE), the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR). Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization [TLR: hazard ratio (HR), 4.07; 95{\%} confidence interval (CI), 1.18–9.34; p = 0.001], target vessel revascularization (TVR: HR, 4.02; 95{\%} CI, 1.93–8.40; p < 0.001), non-TVR (HR, 4.92; 95{\%} CI, 1.68–14.4; p = 0.004) and major adverse cardiac events (MACE: HR, 2.53; 95{\%} CI, 1.60–4.01, p < 0.001) were significantly higher in the RAF group. However, the incidence of total death, non-fatal MI were similar between the two groups. Conclusions: RAF following index PCI with DES in patients with diabetes was associated with increased incidence of revascularization and MACE without changes of death or re-infarction rates and increased TLR and TVR rates in both first- and second-generation DES.",
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author = "Kim, {Yong Hoon} and Her, {Ae Young} and Choi, {Byoung Geol} and Choi, {Se Yeon} and Byun, {Jae Kyeong} and Yoonjee Park and Baek, {Man Jong} and Ryu, {Yang Gi} and Ahmed Mashaly and Jang, {Won Young} and Woohyeun Kim and Park, {Eun Jin} and Choi, {Jah Yeon} and Na, {Jin Oh} and Choi, {Cheol Ung} and Lim, {Hong Euy} and Kim, {Eung Ju} and Park, {Chang Gyu} and Seo, {Hong Seog} and Seung-Woon Rha",
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T1 - Routine angiographic follow-up versus clinical follow-up in patients with diabetes following percutaneous coronary intervention with drug-eluting stents in Korean population

AU - Kim, Yong Hoon

AU - Her, Ae Young

AU - Choi, Byoung Geol

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Park, Yoonjee

AU - Baek, Man Jong

AU - Ryu, Yang Gi

AU - Mashaly, Ahmed

AU - Jang, Won Young

AU - Kim, Woohyeun

AU - Park, Eun Jin

AU - Choi, Jah Yeon

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 - Rha, Seung-Woon

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Aims: The usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in patients with diabetes is not well understood. We compare 3-year clinical outcomes of RAF and CF in diabetic patients underwent PCI with drug-eluting stents (DES). Methods: A total of 843 patients with diabetes who underwent PCI with DES were enrolled. RAF was performed at 6–9 months after PCI (n = 426). Rest of patients were medically managed and clinically followed (n = 417); symptom-driven events were captured. After propensity score matched analysis, 2 propensity-matched groups (262 pairs, n = 524, C-statistic = 0.750) were generated. The primary endpoint was major adverse cardiac events (MACE), the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR). Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization [TLR: hazard ratio (HR), 4.07; 95% confidence interval (CI), 1.18–9.34; p = 0.001], target vessel revascularization (TVR: HR, 4.02; 95% CI, 1.93–8.40; p < 0.001), non-TVR (HR, 4.92; 95% CI, 1.68–14.4; p = 0.004) and major adverse cardiac events (MACE: HR, 2.53; 95% CI, 1.60–4.01, p < 0.001) were significantly higher in the RAF group. However, the incidence of total death, non-fatal MI were similar between the two groups. Conclusions: RAF following index PCI with DES in patients with diabetes was associated with increased incidence of revascularization and MACE without changes of death or re-infarction rates and increased TLR and TVR rates in both first- and second-generation DES.

AB - Aims: The usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in patients with diabetes is not well understood. We compare 3-year clinical outcomes of RAF and CF in diabetic patients underwent PCI with drug-eluting stents (DES). Methods: A total of 843 patients with diabetes who underwent PCI with DES were enrolled. RAF was performed at 6–9 months after PCI (n = 426). Rest of patients were medically managed and clinically followed (n = 417); symptom-driven events were captured. After propensity score matched analysis, 2 propensity-matched groups (262 pairs, n = 524, C-statistic = 0.750) were generated. The primary endpoint was major adverse cardiac events (MACE), the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR). Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization [TLR: hazard ratio (HR), 4.07; 95% confidence interval (CI), 1.18–9.34; p = 0.001], target vessel revascularization (TVR: HR, 4.02; 95% CI, 1.93–8.40; p < 0.001), non-TVR (HR, 4.92; 95% CI, 1.68–14.4; p = 0.004) and major adverse cardiac events (MACE: HR, 2.53; 95% CI, 1.60–4.01, p < 0.001) were significantly higher in the RAF group. However, the incidence of total death, non-fatal MI were similar between the two groups. Conclusions: RAF following index PCI with DES in patients with diabetes was associated with increased incidence of revascularization and MACE without changes of death or re-infarction rates and increased TLR and TVR rates in both first- and second-generation DES.

KW - Clinical follow-up

KW - Diabetes

KW - Drug-eluting stent

KW - Percutaneous coronary intervention

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