The effect of follow-up reexamination on the long-term prognosis of patients with acute coronary syndrome undergoing coronary angiography

Patients with acute coronary syndrome (ACS) remain at high risk for recurrent adverse cardiovascular events after discharge. Patient adherence to secondary prevention is poor. This study proposes a follow-up center-based secondary prevention program to assess whether a structured cardiologist-led follow-up and reexamination protocol influences ACS patient prognosis. A total of 9,534 ACS patients undergoing coronary angiography were retrospectively included and divided into a reexamination group (n = 6,804) and a non-reexamination group (n = 2,730) according to whether they were reexamined within one year or not. The patients were followed up after discharge for 3 years, and clinical outcomes were recorded. The primary outcome was cardiac death. Reexamination within 12 months was significantly associated with a reduced risk of cardiac death (adjusted hazard ratio [aHR], 0.58; 95% confidence interval [CI], 0.44–0.75) at 3 years after ACS. Among patients who underwent reexamination, the risk of cardiac death was 50% lower (aHR, 0.50; 95% CI, 0.35–0.70) and 63% lower (aHR, 0.37; 95% CI, 0.20–0.67) in the high-frequency (more than or equal to 2 times within one year) and long-term (continued reexamination after the first year of follow-up) reexamination groups, respectively. Similar results were observed after propensity score matching analysis. Participation in a structured follow-up and reexamination programme significantly reduces the risk of cardiac death among ACS survivors. Establishing a follow-up center could be of great significance in improving patient prognoses.