There was no long-term clinical benefit to routine follow-up coronary angiography after percutaneous coronary intervention (PCI), according to the results of the ReACT Trial presented Nov. 1 at TCT 2016 and simultaneously published in JACC: Cardiovascular Interventions.

In a prospective, multicenter, open label, randomized study, led by Hiroki Shiomi, MD, researchers assigned patients who underwent successful PCI in Japan (n=700) to either the routine angiographic follow-up group, in which they received coronary angiography at 8 – 12 months after PCI, or the clinical follow-up group. The primary endpoint was defined as a composite of death, myocardial infarction, stroke, emergency hospitalization for acute coronary syndrome, or hospitalization for congestive heart failure during a minimum of 1.5 years follow-up.

The results of the study showed that although there was a greater incidence of repeat revascularization at one year among patients in the angiographic follow-up group, during the median 4.6 years follow-up, the cumulative five-year incidence of the primary endpoint was no different between groups. There were also no significant differences between the angiographic and clinical follow-up groups in terms of any other clinical endpoints. Coronary revascularization within the first year was more frequently performed in the angiographic follow-up group than in clinical follow-up group (12.8 vs. 3.8 percent), although the difference between the two groups attenuated over time with similar cumulative five-year incidence (19.6 vs. 18.1 percent).

According to the authors, “routine follow-up coronary angiography after PCI cannot be recommended as a clinical strategy. However, the present study was underpowered to detect modest benefits or harm of routine follow-up coronary angiography, and larger-scale trials, especially in high-risk patients, are warranted to definitively address this issue.” 

Keywords: Transcatheter Cardiovascular Therapeutics, Angina, Stable, Angiography, Coronary Vessels, Stents, Coronary Angiography, Acute Coronary Syndrome, Follow-Up Studies, Heart Failure, Hospitalization, Japan, Myocardial Infarction, Percutaneous Coronary Intervention, Prospective Studies, Research Personnel, Stroke

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