Key result
Routine angiographic follow-up after LMCA PCI linked to ~49% lower mortality vs clinical follow-up.
Why the study?
The prognostic value of angiographic follow-up after PCI of the left main coronary artery remains uncertain.
Cohort (n=217)
Answers are grounded in this paper and cite their sources.
Angiographic follow-up after LMCA PCI was associated with lower mortality; leaves open whether routine surveillance improves outcomes prospectively.
Prognostic value of angiographic follow-up in patients undergoing percutaneous coronary interventions (PCIs) of the left main coronary artery (LMCA) still remains uncertain. The aim of the study was to compare clinical characteristics, mortality, and major cardiovascular events in patients with versus without angiographic follow-up after PCI of the LMCA as well as to identify independent risk factors for death after PCI of the LMCA. Study population consisted of 217 patients of 290 consecutive participants who underwent PCI of the LMCA and subsequently were divided into 2 groups: angiographic follow-up group (angio FU group, n = 155) and clinical follow-up group (clinical FU group, n = 62). In angio FU group, significantly lower mortality (19.4% vs 32.3%, P < .05) and higher repeated revascularization rates (PCI: 46.5% vs 8.1%, P < .001 and coronary artery bypass grafting: 12.9% vs 1.6%, P < .05) were observed. Independent risk factors for death were as follows: metal stent implantation (hazard ratio [HR]: 2.753), no angiographic follow-up (HR: 1.959), and an increase in serum creatinine level of 1 μmol/L (HR: 1.006). These preliminary data suggest that the lack of angiographic follow-up after PCI of the LMCA may result in higher long-term mortality.
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Mencel et al. (2015) conducted a cohort in Left main coronary artery disease requiring PCI (n=217). Angiographic follow-up vs. Clinical follow-up was evaluated on Mortality (HR 1.959 (for no angiographic follow-up), p=< .05). Routine angiographic follow-up after PCI of the left main coronary artery was associated with significantly lower mortality compared to clinical follow-up alone (19.4% vs 32.3%, P<0.05).
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