title: Routine angiographic follow-up versus clinical follow-up in patients with multivessel coronary artery diseases following percutaneous coronary intervention with drug-eluting stents: a nested case-control study within a Korean population.
abstract: OBJECTIVE
  The difference in the usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after a percutaneous coronary intervention (PCI) in multivessel coronary artery disease (MVD) patients has not been well clarified as yet.
  
  
  METHODS
  A total of 642 consecutive MVD patients who underwent PCI with drug-eluting stents (DES) were enrolled. RAF was performed at 6-9 months after the index PCI (n=374) and others were medically managed and clinically followed (n=268). Patients who experienced clinical events including death, myocardial infarction (MI), and ischemia-driven PCI before 1 year were excluded. To adjust for any potential confounders, a propensity scorematched analysis was carried out using the logistic regression model and two propensity-matched groups (193 pairs, n=386, C-statistic=0.744) were generated. Cumulative clinical outcomes 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 revascularization [target lesion revascularization: odds ratio (OR), 4.21; 95% confidence interval (CI), 1.67-10.6; P=0.001) and target vessel revascularization (TVR: OR, 4.69; 95% CI, 2.00-11.0; P<0.001, target vessel revascularization: OR, 4.69; 95% CI, 2.00-1011.0; P<0.001] and major adverse cardiovascular events (composite of death, repeat PCI and MI: OR, 2.96; 95% CI, 1.62-105.42, P<0.001) were significantly higher in the RAF group compared with the CF group. However, the 3-year incidence of death (OR, 1.41; 95% CI, 0.44-104.53; P=0.558) or MI (OR, 2.58; 95% CI, 0.79-108.37; P=0.102) was not different between the two groups. In MVD patients treated with second-generation DESs, the incidence of repeat revascularization (target lesion revascularization and target vessel revascularization) was not different between the two groups.
  
  
  CONCLUSIONS
  Conclusion RAF following index PCI with DES in multivessel CAD patients was associated with increased incidence of revascularization and major adverse cardiovascular events. However, in MVD patients treated with second-generation DESs, repeat revascularization incidence was similar between two different follow-up strategies up to 3 years.
authors.affiliation: aDepartment of Internal Medicine, Division of Cardiology, Kangwon National University School of Medicine, Chuncheon bCardiovascular Center cDepartment of Medicine, Korea University Graduate School, Seoul, South Korea.
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Ae-Young
authors.initials: AY
authors.lastname: Her
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Byoung Geol
authors.initials: BG
authors.lastname: Choi
authors.forename: Minsuk
authors.initials: M
authors.lastname: Shim
authors.forename: Se Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Jae Kyeong
authors.initials: JK
authors.lastname: Byun
authors.forename: Hu
authors.initials: H
authors.lastname: Li
authors.forename: Woohyeun
authors.initials: W
authors.lastname: Kim
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Kang
authors.forename: Jah Yeon
authors.initials: JY
authors.lastname: Choi
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Park
authors.forename: Sung-Hun
authors.initials: SH
authors.lastname: Park
authors.forename: Sunki
authors.initials: S
authors.lastname: Lee
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death / Q000639:trends; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome