Influence of planned six-month follow-up angiography on late outcome afterpercutaneous coronary intervention - A randomized study

OBJECTIVES The goal of this research was to study the effect of planned ang iography on late clinical outcome after percutaneous coronary intervention. BACKGROUND It is still largely unknown whether planned follow-up angiograph y after coronary angioplasty influences late outcome. METHODS Randomization assigned 527 patients to clinical follow-up alone and 531 to clinical and six-month angiographic follow-up. The effect of planne d angiography on clinical outcome at one and three years after coronary ang ioplasty was studied. RESULTS The two groups were well matched. At one year, more events occurred in the angiographic group than in the clinical group: 122 (23.2%) versus 8 8 (16.7%) (p = 0.01). While the incidence of death or myocardial infarction (MI) was similar at one year, the revascularization rate was higher in the angiographic group: 113 (21.3%) versus 67 (12.7%) (relative risk = 1.7, 95 % confidence interval: 1.3 to 2.3, p = 0.0003). At three years, still more events had occurred in the angiographic group (146 [34.5%] vs. 114 [26.3%], p = 0.03). Adore reinterventions did not improve late survival. However, t here was a nonsignificant reduction in MI (7 [1.3%] vs. 13 [2.5%], p = NS) and a significant improvement in functional class at the end of follow-up ( freedom from angina 81% vs. 74%, p = 0.03). The effect of follow-up angiogr aphy on the reintervention rate was similar for stented and nonstented pati ents. CONCLUSIONS Planned follow-up angiography to evaluate the late results of c oronary intervention led to a 1.7 times higher reintervention rate. This ef fect was similar for stented and nonstented patients. More reinterventions did not improve survival but tended to reduce the incidence of MI and led t o a significantly better functional class at follow-up. (C) 2001 by the Ame rican College of Cardiology.