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

Korean J Intern Med. 2015 Jan;30(1):49-55. doi: 10.3904/kjim.2015.30.1.49. Epub 2014 Dec 30.

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.

Keywords: Coronary angiography; Drug-eluting stents; Follow-up.

Publication types

  • Observational Study

MeSH terms

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