Post PCI follow up: Difference between revisions
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==Overview== | ==Overview== | ||
==Post PCI follow up== | ==Post PCI follow up== | ||
One of the major complications which may occur post PCI includes restenosis and there has been a conflicting evidence on benefits of coronary angiography versus clinical follow up to detect this complication and survival outcome. According to AHA guidelines, routine periodic [[stress testing]] of [[asymptomatic]] patients after PCI without specific clinical indications should not be performed.<ref name="pmid15019882">{{cite journal|author=Eisenberg MJ, Blankenship JC, Huynh T, Azrin M, Pathan A, Sedlis S, Panja M, Starling MR, Beyar R, Azoulay A, Caron J, Pilote L |title=Evaluation of routine functional testing after percutaneous coronary intervention |journal=[[The American Journal of Cardiology]] |volume=93|issue=6 |pages=744–7 |year=2004 |month=March |pmid=15019882|doi=10.1016/j.amjcard.2003.11.071|url=http://linkinghub.elsevier.com/retrieve/pii/S000291490301717X |accessdate=2011-12-16}}</ref> According to one study, coronary stenting maintains its efficacy for about 7-11 years in follow up. However, 4 years after follow up there is increased incidence of restenosis which warrants need for regular follow up.<ref name="pmid10490586">{{cite journal| author=van Domburg RT, Foley DP, de Jaegere PP, de Feyter P, van den Brand M, van der Giessen W et al.| title=Long term outcome after coronary stent implantation: a 10 year single centre experience of 1000 patients. | journal=Heart | year= 1999 | volume= 82 Suppl 2 | issue= | pages= II27-34 | pmid=10490586 | doi= | pmc=1766511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10490586 }} </ref> Another study proposed that clinical follow up is crucial post PCI to detect complications such as restenosis. However, patients with high risk of restenosis may require coronary angiography regardless of the results of non invasive testing<ref name="pmid23437032">{{cite journal| author=Rassaf T, Steiner S, Kelm M| title=Postoperative care and follow-up after coronary stenting. | journal=Dtsch Arztebl Int | year= 2013 | volume= 110 | issue= 5 | pages= 72-81; quiz 82 | pmid=23437032 | doi=10.3238/arztebl.2013.0072 | pmc=3576602 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23437032 }} </ref>. In the recent ReACT trial 2016, it is demonstrated that there is no difference in clinical benefit when coronary angiography is compared to regular clinical follow up after PCI. According to the study there was increased incidence of coronary revascularization with corornary angiography but there was no difference in primary endpoint which included composite of death, MI, stroke, or emergency hospitalizations for acute coronary syndrome or heart failure when compared to regular clinical follow up. | One of the major complications which may occur post PCI includes restenosis and there has been a conflicting evidence on benefits of coronary angiography versus clinical follow up to detect this complication and survival outcome. According to AHA guidelines, routine periodic [[stress testing]] of [[asymptomatic]] patients after PCI without specific clinical indications should not be performed.<ref name="pmid15019882">{{cite journal|author=Eisenberg MJ, Blankenship JC, Huynh T, Azrin M, Pathan A, Sedlis S, Panja M, Starling MR, Beyar R, Azoulay A, Caron J, Pilote L |title=Evaluation of routine functional testing after percutaneous coronary intervention |journal=[[The American Journal of Cardiology]] |volume=93|issue=6 |pages=744–7 |year=2004 |month=March |pmid=15019882|doi=10.1016/j.amjcard.2003.11.071|url=http://linkinghub.elsevier.com/retrieve/pii/S000291490301717X |accessdate=2011-12-16}}</ref> According to one study, coronary stenting maintains its efficacy for about 7-11 years in follow up. However, 4 years after follow up there is increased incidence of restenosis which warrants need for regular follow up.<ref name="pmid10490586">{{cite journal| author=van Domburg RT, Foley DP, de Jaegere PP, de Feyter P, van den Brand M, van der Giessen W et al.| title=Long term outcome after coronary stent implantation: a 10 year single centre experience of 1000 patients. | journal=Heart | year= 1999 | volume= 82 Suppl 2 | issue= | pages= II27-34 | pmid=10490586 | doi= | pmc=1766511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10490586 }} </ref> Another study proposed that clinical follow up is crucial post PCI to detect complications such as restenosis. However, patients with high risk of restenosis may require coronary angiography regardless of the results of non invasive testing<ref name="pmid23437032">{{cite journal| author=Rassaf T, Steiner S, Kelm M| title=Postoperative care and follow-up after coronary stenting. | journal=Dtsch Arztebl Int | year= 2013 | volume= 110 | issue= 5 | pages= 72-81; quiz 82 | pmid=23437032 | doi=10.3238/arztebl.2013.0072 | pmc=3576602 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23437032 }} </ref>. In the recent ReACT trial 2016, it is demonstrated that there is no difference in clinical benefit when coronary angiography is compared to regular clinical follow up after PCI. According to the study there was increased incidence of coronary revascularization with corornary angiography after one year following PCI but there was no difference in primary endpoint which included composite of death, MI, stroke, or emergency hospitalizations for acute coronary syndrome or heart failure when compared to regular clinical follow up after 5 years. | ||
==References== | ==References== | ||
Revision as of 23:28, 1 November 2016
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Percutaneous coronary intervention Microchapters |
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PCI Complications |
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PCI in Specific Patients |
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PCI in Specific Lesion Types |
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Post PCI follow up On the Web |
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American Roentgen Ray Society Images of Post PCI follow up |
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Directions to Hospitals Treating Percutaneous coronary intervention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief:; Aysha Anwar, M.B.B.S[2]
Overview
Post PCI follow up
One of the major complications which may occur post PCI includes restenosis and there has been a conflicting evidence on benefits of coronary angiography versus clinical follow up to detect this complication and survival outcome. According to AHA guidelines, routine periodic stress testing of asymptomatic patients after PCI without specific clinical indications should not be performed.[1] According to one study, coronary stenting maintains its efficacy for about 7-11 years in follow up. However, 4 years after follow up there is increased incidence of restenosis which warrants need for regular follow up.[2] Another study proposed that clinical follow up is crucial post PCI to detect complications such as restenosis. However, patients with high risk of restenosis may require coronary angiography regardless of the results of non invasive testing[3]. In the recent ReACT trial 2016, it is demonstrated that there is no difference in clinical benefit when coronary angiography is compared to regular clinical follow up after PCI. According to the study there was increased incidence of coronary revascularization with corornary angiography after one year following PCI but there was no difference in primary endpoint which included composite of death, MI, stroke, or emergency hospitalizations for acute coronary syndrome or heart failure when compared to regular clinical follow up after 5 years.
References
- ↑ Eisenberg MJ, Blankenship JC, Huynh T, Azrin M, Pathan A, Sedlis S, Panja M, Starling MR, Beyar R, Azoulay A, Caron J, Pilote L (2004). "Evaluation of routine functional testing after percutaneous coronary intervention". The American Journal of Cardiology. 93 (6): 744–7. doi:10.1016/j.amjcard.2003.11.071. PMID 15019882. Retrieved 2011-12-16. Unknown parameter
|month=ignored (help) - ↑ van Domburg RT, Foley DP, de Jaegere PP, de Feyter P, van den Brand M, van der Giessen W; et al. (1999). "Long term outcome after coronary stent implantation: a 10 year single centre experience of 1000 patients". Heart. 82 Suppl 2: II27–34. PMC 1766511. PMID 10490586.
- ↑ Rassaf T, Steiner S, Kelm M (2013). "Postoperative care and follow-up after coronary stenting". Dtsch Arztebl Int. 110 (5): 72–81, quiz 82. doi:10.3238/arztebl.2013.0072. PMC 3576602. PMID 23437032.