No lasting benefit for follow-up coronary angiography after PCI
(HealthDay)—For patients who have undergone percutaneous coronary intervention (PCI), routine follow-up coronary angiography (FUCAG) has no long-term clinical benefit, according to a study published online Jan. 1 in JACC: Cardiovascular Interventions.
Hiroki Shiomi, M.D., from Kyoto University in Japan, and colleagues examined the long-term clinical impact of routine FUCAG after PCI in a prospective multicenter open-label randomized trial. Participants who underwent PCI were randomly allocated to routine angiographic follow-up (AF), in which they received FUCAG at eight to 12 months after PCI, or clinical follow-up alone (CF). Seven hundred patients were enrolled and randomized to AF (349 patients) or CF (351 patients).
The researchers found that the cumulative five-year incidence of the primary end point (composite of death, myocardial infarction, stroke, emergency hospitalization for acute coronary syndrome, or hospitalization for heart failure) was 22.4 and 24.7 percent in the AF and CF groups, respectively (hazard ratio, 0.94; 95 percent confidence interval, 0.67 to 1.31; P = 0.7). Within the first year, any coronary revascularization was performed more frequently in the AF group than the CF group (12.8 versus 3.8 percent; log-rank P < 0.001); over time the difference was attenuated with similar cumulative five-year incidence (19.6 versus 18.1 percent; log-rank P = 0.92).
"Routine FUCAG cannot be recommended as a clinical strategy," the authors conclude. "However, the present study was underpowered to detect modest benefits (or harm) of routine FUCAG, and larger scale trials (especially in high-risk patients) are warranted to definitively address this issue."
One author disclosed ties to Boston Scientific Corp.
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