The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Choi, Seonghoon (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Mun, Hee-Sun (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kang, Min-Kyung (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Cho, Jung Rae (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Han, Seong Woo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Namho (Department of Internal Medicine, Hallym University College of Medicine)
  • Received : 2014.07.10
  • Accepted : 2014.11.10
  • Published : 2015.01.01
⟨ Previous Next ⟩

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

References

  1. Stone GW, Midei M, Newman W, et al. Comparison of an everolimus-eluting stent and a paclitaxel-eluting stent in patients with coronary artery disease: a randomized trial. JAMA 2008;299:1903-1913. https://doi.org/10.1001/jama.299.16.1903
  2. Stone GW, Midei M, Newman W, et al. Randomized comparison of everolimus-eluting and paclitaxel-eluting stents: two-year clinical follow-up from the Clinical Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients with de novo Native Coronary Artery Lesions (SPIRIT) III trial. Circulation 2009;119:680-686. https://doi.org/10.1161/CIRCULATIONAHA.108.803528
  3. Meredith IT, Worthley S, Whitbourn R, et al. Clinical and angiographic results with the next-generation resolute stent system: a prospective, multicenter, first-in-human trial. JACC Cardiovasc Interv 2009;2:977-985. https://doi.org/10.1016/j.jcin.2009.07.007
  4. Mukherjee D, Moliterno DJ. Second-generation drug-eluting stents and the continuous need for rapidly available real-world data. JACC Cardiovasc Interv 2009;2:1236-1239. https://doi.org/10.1016/j.jcin.2009.10.010
  5. Meredith IT, Worthley SG, Whitbourn R, et al. Long-term clinical outcomes with the next-generation resolute stent system: a report of the two-year follow-up from the RESOLUTE clinical trial. EuroIntervention 2010;5:692-697. https://doi.org/10.4244/EIJV5I6A114
  6. Raber L, Magro M, Stefanini GG, et al. Very late coronary stent thrombosis of a newer-generation everolimus-eluting stent compared with early-generation drug-eluting stents: a prospective cohort study. Circulation 2012;125:1110-1121. https://doi.org/10.1161/CIRCULATIONAHA.111.058560
  7. Uchida T, Popma J, Stone GW, et al. The clinical impact of routine angiographic follow-up in randomized trials of drug-eluting stents: a critical assessment of "oculostenotic" reintervention in patients with intermediate lesions. JACC Cardiovasc Interv 2010;3:403-411. https://doi.org/10.1016/j.jcin.2010.01.010
  8. Rupprecht HJ, Espinola-Klein C, Erbel R, et al. Impact of routine angiographic follow-up after angioplasty. Am Heart J 1998;136(4 Pt 1):613-619. https://doi.org/10.1016/S0002-8703(98)70007-9
  9. Ruygrok PN, Melkert R, Morel MA, et al. Does angiography six months after coronary intervention influence management and outcome? Benestent II Investigators. J Am Coll Cardiol 1999;34:1507-1511. https://doi.org/10.1016/S0735-1097(99)00380-0
  10. ten Berg JM, Kelder JC, Suttorp MJ, Verheugt FW, Thijs Plokker HW. Influence of planned six-month follow-up angiography on late outcome after percutaneous coronary intervention: a randomized study. J Am Coll Cardiol 2001;38:1061-1069. https://doi.org/10.1016/S0735-1097(01)01476-0
  11. Schuhlen H, Kastrati A, Mehilli J, et al. Restenosis detected by routine angiographic follow-up and late mortality after coronary stent placement. Am Heart J 2004;147:317-322. https://doi.org/10.1016/j.ahj.2003.10.002
  12. Pinto DS, Stone GW, Ellis SG, et al. Impact of routine angiographic follow-up on the clinical benefits of paclitaxel-eluting stents: results from the TAXUS-IV trial. J Am Coll Cardiol 2006;48:32-36. https://doi.org/10.1016/j.jacc.2006.02.060
  13. Shimada K, Kasanuki H, Hagiwara N, Ogawa H, Yamaguchi N. Routine coronary angiographic follow-up and subsequent revascularization in patients with acute myocardial infarction. Heart Vessels 2008;23:383-389. https://doi.org/10.1007/s00380-008-1060-y
  14. Topol EJ, Nissen SE. Our preoccupation with coronary luminology: the dissociation between clinical and angiographic findings in ischemic heart disease. Circulation 1995;92:2333-2342. https://doi.org/10.1161/01.CIR.92.8.2333
  15. Lansky AJ, Brar SS, Yaqub M, et al. Impact of routine angiographic follow-up after percutaneous coronary intervention with drug-eluting stents in the SPIRIT III randomized trial at three years. Am J Cardiol 2012;110:21-29. https://doi.org/10.1016/j.amjcard.2012.02.040
  16. Stone GW, Parise H, Witzenbichler B, et al. Selection criteria for drug-eluting versus bare-metal stents and the impact of routine angiographic follow-up: 2-year insights from the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial. J Am Coll Cardiol 2010;56:1597-1604. https://doi.org/10.1016/j.jacc.2010.08.608
  17. Stone GW, Moses JW, Ellis SG, et al. Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. N Engl J Med 2007;356:998-1008. https://doi.org/10.1056/NEJMoa067193
  18. Stefanini GG, Kalesan B, Serruys PW, et al. Long-term clinical outcomes of biodegradable polymer biolimus- eluting stents versus durable polymer sirolimus-eluting stents in patients with coronary artery disease (LEADERS): 4 year follow-up of a randomised non-inferiority trial. Lancet 2011;378:1940-1948. https://doi.org/10.1016/S0140-6736(11)61672-3
  19. Camenzind E, Wijns W, Mauri L, et al. Stent thrombosis and major clinical events at 3 years after zotarolimus-eluting or sirolimus-eluting coronary stent implantation: a randomised, multicentre, open-label, controlled trial. Lancet 2012;380:1396-1405. https://doi.org/10.1016/S0140-6736(12)61336-1
  20. Kandzari DE, Mauri L, Popma JJ, et al. Late-term clinical outcomes with zotarolimus- and sirolimus-eluting stents: 5-year follow-up of the ENDEAVOR III (a randomized controlled trial of the medtronic endeavor Drug [ABT-578] eluting coronary stent system versus the cypher sirolimus-eluting coronary stent system in de novo native coronary artery lesions). JACC Cardiovasc Interv 2011;4:543-550. https://doi.org/10.1016/j.jcin.2010.12.014
  21. Stefanini GG, Byrne RA, Serruys PW, et al. Biodegradable polymer drug-eluting stents reduce the risk of stent thrombosis at 4 years in patients undergoing percutaneous coronary intervention: a pooled analysis of individual patient data from the ISAR-TEST 3, ISAR-TEST 4, and LEADERS randomized trials. Eur Heart J 2012;33:1214-1222. https://doi.org/10.1093/eurheartj/ehs086
  22. Park TK, Song YB, Gwag HB, et al. Aspirin versus clopidogrel following dual antiplatelet therapy on the era of drug eluting stents. J Am Coll Cardiol 2014;63(12 Suppl):A1612. https://doi.org/10.1016/S0735-1097(14)61615-6
  23. Kip KE, Hollabaugh K, Marroquin OC, Williams DO. The problem with composite end points in cardiovascular studies: the story of major adverse cardiac events and percutaneous coronary intervention. J Am Coll Cardiol 2008;51:701-707. https://doi.org/10.1016/j.jacc.2007.10.034

Cited by

  1. The Impact of In-stent Restenosis Detected upon Routine Follow-up Angiography after Percutaneous Coronary Intervention with Metallic Stent vol.9, pp.2, 2015, https://doi.org/10.17264/stmarieng.9.53