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ȣ - 540365 204 |
Routine Follow Up Coronary Angiography versus Clinical Follow Up only in Acute ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Drug-eluting Stents |
고려대학교 구로병원 순환기내과¹, 을지병원 심장내과², Cardiology Department, the Second Hospital of Tianjin Medical University, Tianjin, China³, Cardiology Department, Nankai Hospital, Tianjin Medical University, Tianjin, China⁴ |
나승운¹, Kanhaiya L. Poddar¹, Meera Kumari¹, 박지영², 최병걸¹, Sureshkumar Ramasamy¹, Kang Yin Chen³, Yong Jian Li⁴, 김연경¹, 나진오¹, 최철웅¹, 임홍의¹, 김진원¹, 김응주¹, 박창규¹, 서홍석¹, 오동주¹ |
Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in acute ST elevation myocardial infarction (STEMI) patients (pts) is beneficial or not.
Methods: The study population consisted of 218 consecutive STEMI pts underwent primary PCI from November 2005 to June 2008. Routine FU CAG was performed between 6 to 9 months following index PCI and was decided by individual physician’s discretion. Pts died before 6 months were excluded in both groups. Cumulative clinical outcomes up to 2 years were compared between Routine CAG group (n=150 pts, 75.7%) and Clinical FU group (n= 68 pts, 34.3%).
Results: A total 198 pts (90.8%) were followed up to 2 years. Both groups had similar Baseline clinical and procedural characteristics were similar between the two groups except chronic renal insufficiency was higher in the Clinical FU group (7.4 vs. 1.3, p=0.020). Routine CAG group had lower incidence of cumulative cardiac death and recurrent Q-wave MI up to 2 years, however, there were no difference in the incidence of repeat revascularization and major adverse cardiac events (Table).
Conclusions: In our study, routine CAG FU after successful primary PCI with DESs in pts with STEMI was associated with lower incidence of cardiac death and recurrent Q-wave MI up to 2 years, suggesting better durable long-term clinical outcomes of routine CAG FU strategy compared to clinical FU only strategy.
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Table. Clinical Outcomes at 2Years
Variables, n (%) |
Routine CAG
(n = 150 pts) |
Clinical F/U
(n = 68 pts) |
P Value |
Cardiac death |
0 (0.0) |
3 (5.7) |
0.004 |
Q-wave MI |
1 (0.7) |
3 (5.7) |
0.028 |
TLR |
15 (10.3) |
8 (15.1) |
0.356 |
TVR |
22 (15.2) |
8 (15.1) |
0.989 |
TLR-MACE |
14 (9.7) |
9 (17.0) |
0.154 |
TVR-MACE |
21 (14.5) |
12 (22.6) |
0.173 |
All MACE |
25 (17.2) |
13 (24.5) |
0.249 |
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