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ȣ - 490862 16 |
Efficacy of Routine Scheduled Angiographic Follow-up in DES Era: Korean Multicenter Angioplasty Team(COMATE) Registry |
Inje University Sanggyepaik Hospital1, Yonsei University Severance Hospital2, Yongdong Severance Hospital3, Wonju Christian Hospital4, Ehwa Womans Univarsity Mokdong Hospital5, NHIC Ilsan Hospital6, Hallym University Kangnam Sacred Heart Hospital7 |
Choong-Won Goh¹, Young-Sub Byun¹ , Byoung Kwon Lee¹ , Byung Ok Kim¹ , Yangsoo Jang² , Hyuck Moon Kwon³ , Jung Han Yoon⁴ , Si Hoon Park5 , Joo Young Yang6 , Seung-Hyuk Choi7 |
Background. Introduction of drug-eluting stent (DES) dramatically reduced major acute cardiac events (MACE) and restenosis. Many centers still practice scheduled angiographic follow-up (Angio-F/U) after DES treatment. We investigated real world MACE and restenosis rate after DES treatment to find out the necessity and efficacy of scheduled Angio-F/U.
Method and Results. Pooled registry data from April 2003 to January 2005 were used. DESs were implanted on 2121 lesions of 1638 patients (Sirolimus-eluting stent, SES 1442, paclitaxel-eluting stent, PES 679). Scheduled Angio F/U was done in 570 patients (34.8%, 677 stents). Total MACE occurred in 76 patients (4.6% SES 40, 3.5%, PES 36, 7.3%, NS). Deaths were occurred in 26 patients. There were 8 cases of non-fatal myocardial infarction including 4 subacute thrombosis cases. Target lesion revascularization (TLR) was done in 46 patients, 50 lesions. Of all TLR cases 13 patients had coronary symptoms. Other 33 patients had no clinical symptoms at the time of TLR (33/570, 5.8%). Angiographic characteristics of these patients include 13 diffuse long lesions, 10 chronic total occlusion, and 7 in-stent restenosis. Atherosclerotic risk factors were 21 HTN, 9 DM, 9 hypercholesterolemia, 5 smokers, and 3 CRF. Fourteen patients had multiple risk factors.
Conclusion. In DES era, routine scheduled Angio-F/U has low efficacy. But scheduled Angio-F/U is still useful in patients with high-risk angiographic characteristics and/or multiple atherosclerotic risk factors.
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|
Total |
SES |
PES |
lesion |
patients |
lesion |
patients |
lesion |
patients |
Cases |
2121 |
1638 |
1442 |
1145 |
679 |
493 |
Angio
F/U |
677 |
570 |
480 |
399 |
197 |
171 |
MACE |
|
76 |
|
40 |
|
36 |
Death |
|
26 |
|
16 |
|
10 |
MI |
|
8 |
|
4 |
|
4 |
TLR |
50 |
46 |
24 |
21 |
24 |
25 |
Sx(-)TLR |
37 |
33 |
16 |
13 |
19 |
20 |
|
|
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