Post PCI follow up

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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 complications which may occur post PCI includes restenosis and there is a conflicting evidence on usage of coronary angiography versus clinical follow up to detect this complication. 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. 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[2]. 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.

References

  1. 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)
  2. 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.

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