AS-238 Impact of Routine Mid-term Follow Up Coronary Angiography on Two-Year Clinical Outcomes in Diabetic Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

2011 ◽  
Vol 107 (8) ◽  
pp. 91A
Author(s):  
Seung-Woon Rha ◽  
Kanhaiya L. Poddar ◽  
Meera Kumari ◽  
Byoung Geol Choi ◽  
Yun Kyung Kim ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Diabetic Patients ◽  
Percutaneous Coronary ◽  
Drug Eluting

Abstract 13853: Routine Follow Up Coronary Angiography versus Clinical Follow Up Only in Patients With Dyslipidemia Following Percutaneous Coronary Intervention With Drug-eluting Stents: 3-year Clinical Follow Up Results

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Seung Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
Jae Kyeong Byun ◽  
Jin Oh Na ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Control Group ◽  
Cardiac Events ◽  
Repeat Revascularization ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in patients (pts) with dyslipidemia is beneficial or not. Methods: The study population consisted of 554 consecutive dyslipidemia pts underwent PCI with unrestricted utilization of DESs from January 2004 to May 2011. Routine FU CAG was performed between 6 to 9 months following index PCI and was decided by individual physician’s discretion. Rests of the pts were clinically followed and ischemic driven events were captured. Clinical events including mortality, myocardial infarction and clinically driven PCI before 9 months were excluded in both groups. Cumulative clinical outcomes up to 3 years were compared between the Routine CAG group (n=329 pts) and the Clinical FU group (n= 225 pts). To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. Results: After PSM analysis, 2 propensity-matched groups (165 pairs, n = 330 pts, C-statistic=0.718) were generated and, the baseline characteristics of the two groups were balanced. At 3 years, the incidence of repeat revascularization and major adverse cardiac events (MACEs) was higher in the Routine CAG group than the control group (Table). Conclusions: Despite the expected beneficial effects, routine FU CAG following index PCI with DESs in dyslipidemia pts was associated with higher incidence of repeat PCI and MACE up to 3 years.

scholarly journals Endothelial dysfunction as predictor of angina recurrence after successful percutaneous coronary intervention using second generation drug eluting stents

2018 ◽  
Vol 25 (13) ◽  
pp. 1360-1370 ◽  
Author(s):  
Rocco A Montone ◽  
Giampaolo Niccoli ◽  
Federico Vergni ◽  
Vincenzo Vetrugno ◽  
Michele Russo ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Endothelial Dysfunction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background The role of endothelial dysfunction in predicting angina recurrence after percutaneous coronary intervention is unknown. Design We assessed the role of peripheral endothelial dysfunction measured by reactive-hyperaemia peripheral-artery tonometry (RH-PAT) in predicting recurrence of angina after percutaneous coronary intervention. Methods We enrolled consecutive patients undergoing percutaneous coronary intervention with second-generation drug-eluting stents. RH-PAT was measured at discharge. The endpoint was repeated coronary angiography for angina recurrence and/or evidence of myocardial ischaemia at follow-up. Patients with in-stent restenosis and/or significant de novo stenosis were defined as having angina with obstructed coronary arteries (AOCA); all other patients as having angina with non-obstructed coronary arteries (ANOCA). Results Among 100 patients (mean age 66.7 ± 10.4 years, 80 (80.0%) male, median follow-up 16 (3–20) months), AOCA occurred in 14 patients (14%), ANOCA in nine patients (9%). Repeated coronary angiography occurred more frequently among patients in the lower RH-PAT index tertile compared with middle and upper tertiles (14 (41.2%) vs. 6 (18.2%) vs. 3 (9.1%), p = 0.006, respectively). ANOCA was more frequent in the lower RH-PAT index tertile compared with middle and upper tertiles. In the multivariate regression analysis, the RH-PAT index only predicted angina recurrence. The receiver operating characteristic curve of the RH-PAT index to predict the angina recurrence demonstrated an area under the curve of 0.79 (95% confidence interval: 0.69–0.89; p < 0.001), with a cut-off value of 1.705, having sensitivity 74% and specificity 70%. Conclusions Non-invasive assessment of peripheral endothelial dysfunction using RH-PAT might help in the prediction of recurrent angina after percutaneous coronary intervention, thus identifying patients who may need more intense pharmacological treatment and risk factor control.

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