The use of functional tests and planned coronary angiography after percutaneous coronary revascularization in clinical practice. Results from the AFTER multicenter study

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:137

Article

Mazzarotto, Pietro¹  Pristipino, Christian²  Burzotta, Francesco³  Serdoz, Roberto¹²  Berni, Andrea⁴  Sardella, Gennaro⁵  Danesi, Alessandro⁶  Di Sciascio, Germano⁷  Zingales, Leone Dino⁸  Loschiavo, Paolo⁹  Sciahbasi, Alessandro¹⁰  Gioffre, Gaetano¹¹  Gemelli, Francesco¹ 

[1] San Carlo Hosp, Intervent Cardiol Unit, I-00165 Rome, Italy

[2] San Filippo Neri Hosp, Intervent Cardiol Unit, Rome, Italy

[3] Catholic Univ, Inst Cardiol, Rome, Italy

[4] Univ Roma La Sapienza, Dept Cardiol, S Andrea Hosp, Rome, Italy

[5] Univ Roma La Sapienza, Dept Cardiol, Policlin Umberto I, Rome, Italy

[6] Santo Spirito Hosp, Dept Cardiol, Rome, Italy

[7] Campus Biomed Univ, Dept Cardiol, Rome, Italy

[8] Belcolle Hosp, Intervent Cardiol Unit, Viterbo, Italy

[9] Sandro Pertini Hosp, Intervent Cardiol Unit, Rome, Italy

[10] Policlin Casilino, Dept Cardiol, Rome, Italy

[11] St Eugenio Hosp, Dept Cardiol, Rome, Italy

[12] San Pietro Hosp, Dept Cardiol, Rome, Italy

关键词: Percutaneous transluminal coronary angioplasty;    Coronary restenosis;    Heart function tests;    Follow-up studies;   

DOI  :  10.1016/j.ijcard.2008.06.038

来源: Elsevier

【 摘 要 】

Background: The follow-up strategies after percutaneous coronary intervention (PCI) have relevant clinical and economic implications. The purpose of this prospective observational multicenter study was to evaluate the effect of clinical, procedural and organizational variables on the execution of functional testing (FT) and planned coronary angiography (CA) after PCI, and to assess the impact of American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on clinical practice. Methods: Four hundred twenty consecutive patients undergoing PCI were categorized as class I, IIB and III indications for follow-up FT according to ACC/AHA guidelines recommendations. Furthermore, all patients were grouped according to the presence or absence of FT and/or planned CA over 12 months after PCI. Multivariable analysis was used to assess the potential predictors of test execution. Results: During the 12-month follow-up at least one test was performed in 72% of patients with class I indication, 63% of patients with class IIB indication and 75% of patients with class III indication (p=ns). A total of 283 patients (67%) underwent testing. The use of tests was associated with younger age (R. R. 0.94, C. I. 0.91 +/- 0.97, p<0.001), a lower number of diseased vessels (R.R. 0.60, C.I. 0.43 +/- 0.84, p=0.003), follow-up by the center performing PCI (R. R. 2.64, C. I. 1.43 +/- 4.86, p=0.002), and the specific center at which PCI was performed. Most asymptomatic patients completed their testing prematurely with respect to the risk period for restenosis. Conclusions: The use of FT and planned CA after PCI is unrelated to patient's symptom status, and depends on patient's age and logistics. ACC/AHA guidelines have no influence in clinical practice, and test timing is not tailored to the risk period for restenosis. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free