No benefit for follow-up angiography after PCI
The ReAct study examining routine follow-up angiography after PCI showed no long-term benefit compared to clinical follow-up alone.
Results from the 700-patient trial, also published in JACC: Cardiovascular Interventions, showed a greater incidence of repeat revascularization at 1 year among patients in the angiography group. But during the median 4.6 years follow-up, the cumulative 5-year incidence of the primary endpoint was no different between groups (22.4% for the angio cohort compared with 24.7% for the control group).
There were likewise no significant differences between the groups for the other endpoints; coronary revascularization within the 1st year was more frequently performed in the angio group (12.8% vs. 3.8%), although the difference between the 2 groups attenuated over time with similar cumulative 5-year incidence (19.6% vs. 18.1%).
“In this study, routine follow-up coronary angiography after PCI, as compared with clinical follow-up alone, did not bring any significant clinical benefit,” lead investigator Dr. Hiroki Shiomi, of Japan’s Kyoto University Hospital, said in prepared remarks. “Thus, 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 FUCAG, and larger-scale trials, especially in high-risk patients, are warranted to definitively address this issue.”