Routine angiographic follow-up versus clinical follow-up in patients with diabetes following percutaneous coronary intervention with drug-eluting stents in Korean population. (April 2018)

• Record Type: Journal Article
• Authors: Kim, Yong Hoon; Her, Ae-Young; Choi, Byoung Geol; Choi, Se Yeon; Byun, Jae Kyeong; Park, Yoonjee; Baek, Man Jong; Ryu, Yang Gi; Mashaly, Ahmed; Jang, Won Young; Kim, Woohyeun; Park, Eun Jin; Choi, Jah Yeon; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Rha, Seung-Woon
• Is Part Of: Diabetes research and clinical practice. Volume 138(2018)
• Page Start: 138
• Page End: 148
• Publication Date: 2018-04
• Subjects: Diabetes -- Percutaneous coronary intervention -- Drug-eluting stent -- Clinical follow-up; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2018.02.007
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Usefulness of routine angiographic follow-up (RAF) in diabetes is less well known. RAF cause increased incidence of revascularization and major adverse cardiac events. Target lesion revascularization also higher in second-generation drug-eluting stents. Abstract: Aims: The usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in patients with diabetes is not well understood. We compare 3-year clinical outcomes of RAF and CF in diabetic patients underwent PCI with drug-eluting stents (DES). Methods: A total of 843 patients with diabetes who underwent PCI with DES were enrolled. RAF was performed at 6–9 months after PCI (n = 426). Rest of patients were medically managed and clinically followed (n = 417); symptom-driven events were captured. After propensity score matched analysis, 2 propensity-matched groups (262 pairs, n = 524, C-statistic = 0.750) were generated. The primary endpoint was major adverse cardiac events (MACE), the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR). Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization [TLR: hazard ratio (HR), 4.07; 95% confidence interval (CI), 1.18–9.34; p = 0.001], target vessel revascularization (TVR: HR, 4.02; 95% CI, 1.93–8.40; p < 0.001), non-TVR (HR, 4.92; 95% CI, 1.68–14.4; p = 0.004) and major adverse cardiac events (MACE: HR, 2.53; 95% CI, 1.60–4.01, p < 0.001) were significantly higher in the RAF group. However, the incidence of total death, non-fatal MI were similar between the two groups. Conclusions: RAF following index PCI with DES in patients with diabetes was associated with increased incidence of revascularization and MACE without changes of death or re-infarction rates and increased TLR and TVR rates in both first- and second-generation DES.