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Role of Routine Follow-up Coronary Angiography After Percutaneous Coronary Intervention　- Systematic Review and

Naoki Misumida1, Akihiro Kobayashi2, Sun Moon Kim1

  • 1Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky.

Circulation Journal : Official Journal of the Japanese Circulation Society
|August 1, 2017
PubMed

Insights

Routine follow-up coronary angiography after percutaneous coronary intervention may reduce myocardial infarction but increases revascularization. Further research is needed to determine its clinical utility for patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • Previous studies suggest routine coronary angiography (CAG) post-percutaneous coronary intervention (PCI) increases revascularization without clear benefit in major adverse clinical events.
  • Prior research lacked adequate power to assess hard clinical endpoints like myocardial infarction (MI) or death, leaving clinical utility uncertain.

Purpose of the Study:

  • To systematically review and meta-analyze randomized trials comparing outcomes after PCI with and without routine follow-up CAG.
  • To determine the clinical utility of routine follow-up CAG in managing patients post-PCI.

Main Methods:

  • Systematic review and meta-analysis of five randomized trials.
  • Included 4,584 patients comparing routine CAG versus clinical follow-up post-PCI.
  • Analyzed data on myocardial infarction, all-cause mortality, and target lesion revascularization.

Main Results:

  • Routine follow-up CAG was associated with a lower rate of MI (OR 0.65; P=0.01).
  • No significant reduction in all-cause mortality was observed (OR 0.87; P=0.48).
  • A higher rate of target lesion revascularization was noted (OR 1.73; P<0.001).

Conclusions:

  • Routine follow-up CAG after PCI increases revascularization rates.
  • Routine follow-up CAG is associated with a reduced rate of subsequent MI.
  • Further investigation into the role of routine follow-up angiography is warranted.
Abstract

Keywords:
Angiographic follow-upMyocardial infarctionPercutaneous coronary interventionRestenosisRoutine angiography

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