The ReACT Trial: Randomized Evaluation of Routine Follow-up Coronary Angiography After Percutaneous Coronary Intervention Trial

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• 作者：Hiroki Shiomi ; MDup>aup> ; Takeshi Morimoto ; MD ; PhDup>bup> ; Shoji Kitaguchi ; MDup>cup> ; Yoshihisa Nakagawa ; MDup>dup> ; Katsuhisa Ishii ; MDup>eup> ; Yoshisumi Haruna ; MD ; PhDup>cup> ; Itaru Takamisawa ; MDup>fup> ; Makoto Motooka ; MDup>gup> ; Kazuhiro Nakao ; MDup>hup> ; Shintaro Matsuda ; MDup>iup> ; Satoru Mimoto ; MDup>jup> ; Yutaka Aoyama ; MDup>kup> ; Teruki Takeda ; MDup>lup> ; Koichiro Murata ; MDup>mup> ; Masaharu Akao ; MDup>nup> ; Tsukasa Inada ; MDup>oup> ; Hiroshi Eizawa ; MDup>iup> ; Eiji Hyakuna ; MDup>pup> ; Kojiro Awano ; MDup>qup> ; Manabu Shirotani ; MDup>rup> ; Yutaka Furukawa ; MDup>sup> ; Kazushige Kadota ; MDup>tup> ; Katsumi Miyauchi ; MDup>uup> ; Masaru Tanaka ; MDup>oup> ; Yuichi Noguchi ; MDup>vup> ; Sunao Nakamura ; MDup>jup> ; Satoshi Yasuda ; MDup>hup> ; Shunichi Miyazaki ; MDup>wup> ; Hiroyuki Daida ; MDup>uup> ; Kazuo Kimura ; MDup>xup> ; Yuji Ikari ; MDup>yup> ; Haruo Hirayama ; MD ; PhDup>kup> ; Tetsuya Sumiyoshi ; MDup>fup> ; Takeshi Kimura ; MDup>aup>up> ; up>up>taketaka@kuhp.kyoto-u.ac.jpup> ; on behalf of the ReACT InvestigatorsKazuo Kimura ; Kiyoshi Hibi ; Katsuhisa Ishii ; Kazuaki Kataoka ; Takeshi Kimura ; Hiroki Shiomi ; Manabu Shirotani ; Shunichi Miyazaki ; Teruki Takeda ; Satoshi Yasuda ; Kazuhiro Nakao ; Masaharu Akao ; Mitsuru Ishii ; Eiji Momona ; Tetsuya Sumiyoshi ; Itaru Takamisawa ; Hiroyuki Daida ; Katsumi Miyauchi ; Satoru Mimoto ; Sunao Nakamura ; Yutaka Furukawa ; Shintaro Matsuda ; Hiroshi Eizawa ; Akinori Takizawa ; Koichiro Murata ; Masaru Tanaka ; Tsukasa Inada ; Yuichi Noguchi ; Yoshihisa Nakagawa ; Makoto Motooka ; Yuji Ikari ; Kojiro Awano ; Yoshisumi Haruna ; Shoji Kitaguchi ; Haruo Hirayama ; Mamoru Nanasato
• 关键词：angiographic follow-up ; percutaneous coronary intervention ; prognosis ; stent(s)
• 刊名：JACC: Cardiovascular Interventions
• 出版年：2017
• 出版时间：23 January 2017
• 年：2017
• 卷：10
• 期：2
• 页码：109-117
• 全文大小：1360 K
• 卷排序：10

文摘

The purpose of this study was to evaluate long-term clinical impact of routine follow-up coronary angiography (FUCAG) after percutaneous coronary intervention (PCI) in daily clinical practice in Japan.BackgroundThe long-term clinical impact of routine FUCAG after PCI in real-world clinical practice has not been evaluated adequately.MethodsIn this prospective, multicenter, open-label, randomized trial, patients who underwent successful PCI were randomly assigned to routine angiographic follow-up (AF) group, in which patients were to receive FUCAG at 8 to 12 months after PCI, or clinical follow-up alone (CF) group. The primary endpoint was defined as a composite of death, myocardial infarction, stroke, emergency hospitalization for acute coronary syndrome, or hospitalization for heart failure over a minimum of 1.5 years follow-up.ResultsBetween May 2010 and July 2014, 700 patients were enrolled in the trial among 22 participating centers and were randomly assigned to the AF group (n = 349) or the CF group (n = 351). During a median of 4.6 years of follow-up (interquartile range [IQR]: 3.1 to 5.2 years), the cumulative 5-year incidence of the primary endpoint was 22.4% in the AF group and 24.7% in the CF group (hazard ratio: 0.94; 95% confidence interval: 0.67 to 1.31; p = 0.70). Any coronary revascularization within the first year was more frequently performed in AF group than in CF group (12.8% vs. 3.8%; log-rank p < 0.001), although the difference between the 2 groups attenuated over time with a similar cumulative 5-year incidence (19.6% vs. 18.1%; log-rank p = 0.92).ConclusionsNo clinical benefits were observed for routine FUCAG after PCI and early coronary revascularization rates were increased within routine FUCAG strategy in the current trial. (Randomized Evaluation of Routine Follow-up Coronary Angiography After Percutaneous Coronary Intervention Trial [ReACT]; NCT01123291)