The ReACT Trial: Randomized Evaluation of Routine Follow-up Coronary Angiography After Percutaneous Coronary Intervention Trial
Hiroki Shiomi, Takeshi Morimoto, Shoji Kitaguchi, Yoshihisa Nakagawa, Katsuhisa Ishii, Yoshisumi Haruna, Itaru Takamisawa, Makoto Motooka, Kazuhiro Nakao, Shintaro Matsuda, Satoru Mimoto, Yutaka Aoyama, Teruki Takeda, Koichiro Murata, Masaharu Akao, Tsukasa Inada, Hiroshi Eizawa, Eiji Hyakuna, Kojiro Awano, Manabu Shirotani, Yutaka Furukawa, Kazushige Kadota, Katsumi Miyauchi, Masaru Tanaka, Yuichi Noguchi, Sunao Nakamura, Satoshi Yasuda, Shunichi Miyazaki, Hiroyuki Daida, Kazuo Kimura, Yuji Ikari, Haruo Hirayama, Tetsuya Sumiyoshi, Takeshi Kimura, ReACT Investigators, Kazuo 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, Hiroki Shiomi, Takeshi Morimoto, Shoji Kitaguchi, Yoshihisa Nakagawa, Katsuhisa Ishii, Yoshisumi Haruna, Itaru Takamisawa, Makoto Motooka, Kazuhiro Nakao, Shintaro Matsuda, Satoru Mimoto, Yutaka Aoyama, Teruki Takeda, Koichiro Murata, Masaharu Akao, Tsukasa Inada, Hiroshi Eizawa, Eiji Hyakuna, Kojiro Awano, Manabu Shirotani, Yutaka Furukawa, Kazushige Kadota, Katsumi Miyauchi, Masaru Tanaka, Yuichi Noguchi, Sunao Nakamura, Satoshi Yasuda, Shunichi Miyazaki, Hiroyuki Daida, Kazuo Kimura, Yuji Ikari, Haruo Hirayama, Tetsuya Sumiyoshi, Takeshi Kimura, ReACT Investigators, Kazuo 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
Abstract
Objectives: 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.
Background: The long-term clinical impact of routine FUCAG after PCI in real-world clinical practice has not been evaluated adequately.
Methods: In 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.
Results: Between 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).
Conclusions: No 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).
Keywords: angiographic follow-up; percutaneous coronary intervention; prognosis; stent(s).
Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Source: PubMed