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Usefulness of routine angiographic follow-up in diabetic patients following percutaneous coronary intervention with drug-eluting stents: a nested case-control study within korean population

Session Poster session 3

Speaker Yong Hoon Kim

Event : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : YH Kim (Chuncheon City,KR), AY Her (Chuncheon City,KR), SW Rha (Seoul,KP), BG Choi (Seoul,KP), SY Choi (Seoul,KP), JK Byun (Seoul,KP), CU Choi (Seoul,KP), EJ Kim (Seoul,KP), CG Park (Seoul,KP), HS Seo (Seoul,KP), DJ Oh (Seoul,KP)

Authors:
Y.H. Kim1 , A.Y. Her1 , S.W. Rha2 , B.G. Choi2 , S.Y. Choi2 , J.K. Byun2 , C.U. Choi2 , E.J. Kim2 , C.G. Park2 , H.S. Seo2 , D.J. Oh2 , 1Kangwon National University Hospital - Chuncheon City - Korea Republic of , 2Korea University Guro Hospital - Seoul - Korea Republic of ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 515

Background: The usefulness of routine angiographic follow-up (RAF) after percutaneous coronary intervention (PCI) compared with clinical follow-up (CF) in diabetic patients who underwent PCI with drug-eluting stents (DESs) is less well known

Purpose: To compare 3-year clinical outcomes of RAF and CF in diabetic patients

Methods: A total of 843 consecutive diabetic patients who underwent PCI with DESs were enrolled. RAF was performed at 6 to 9 months after the index PCI (n=426). Rest of patients were medically managed and clinically followed (n=417).After propensity score matched (PSM) analysis, 2 propensity-matched groups (262 pairs, n=524, C-statistic = 0.750) were generated. Major adverse cardiac events up to 3 years were compared between the RAF group and the CF group.

Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization (TLR, HR, 4.07; 95% 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 MACEs (HR, 2.53; 95% CI, 1.60–4.01, p<0.001) were higher in the RAF group compared with the CF group. (Table and Figure)

Conclusions: RAF following index PCI with DESs in diabetic patients was associated with higher incidence of revascularization and MACEs than CF alone without benefit of mortality or MI reduction.

Cumulative clinical follow-up outcomes between one to three years
Variable, N (%)TotalRAFCFp valueHazard ratiop value
(n=524)(n=262)(n=262)(95% CI)
Total death22 (4.2)9 (3.4)13 (5.0)0.3840.48 (0.16–1.42)0.186
Cardiac death8 (1.5)3 (1.1)5 (1.9)0.7240.51 (0.08–3.09)0.467
Non-cardiac death14 (2.7)6 (2.3)8 (3.1)0.7880.75 (0.26–2.15)0.586
Myocardial infarction: MI14 (2.7)7 (2.7)7 (2.7)NS1.11 (0.35–3.52)0.847
ST segment elevation MI4 (0.8)0 (0.0)4 (1.5)0.1242.85 (0-)0.984
Non-ST segment elevation MI10 (2.0)7 (2.7)3 (1.1)0.3392.30 (0.60–8.90)0.227
Revascularizations63 (12.0)51 (19.5)12 (4.6)<0.0014.63 (2.47–8.68)<0.001
TLR34 (6.5)27 (10.3)7 (2.7)<0.0014.07 (1.18–9.34)0.001
TVR43 (8.2)34 (13.0)9 (3.4)<0.0014.02 (1.93–8.40)<0.001
Non-TVR23 (4.4)19 (7.3)4 (1.5)0.0014.92 (1.68–14.4)0.004
Stent thrombosis3 (0.6)1 (0.4)2 (0.8)NS0.00 (0-)0.998
Total MACE86 (16.4)60 (22.9)26 (9.9)<0.0012.53 (1.60–4.01)<0.001
TLR MACE42 (8.0)29 (11.1)13 (5.0)0.0102.42 (1.26–4.66)0.008
TVR MACE68 (13.0)44 (16.8)24 (9.2)0.0092.01 (1.22–3.30)0.006
Follow-up, day1073±1141077±1071070±120NS

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