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Routine stress testing in diabetic patients after percutaneous coronary intervention: the POST-PCI trial.
Kim, Hoyun; Kang, Do-Yoon; Lee, Jinho; Choi, Yeonwoo; Ahn, Jung-Min; Kim, Seonok; Yoon, Yong-Hoon; Hur, Seung-Ho; Lee, Cheol Hyun; Kim, Won-Jang; Kang, Se Hun; Park, Chul Soo; Lee, Bong-Ki; Suh, Jung-Won; Choi, Jae Woong; Kim, Kee-Sik; Lee, Su Nam; Park, Seung-Jung; Park, Duk-Woo.
Afiliación
  • Kim H; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
  • Kang DY; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
  • Lee J; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
  • Choi Y; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
  • Ahn JM; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
  • Kim S; Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Yoon YH; Division of Cardiology, Chungnam National University Sejong Hospital, Sejong, South Korea.
  • Hur SH; Division of Cardiology, Keimyung University Dongsan Hospital, Daegu, South Korea.
  • Lee CH; Division of Cardiology, Keimyung University Dongsan Hospital, Daegu, South Korea.
  • Kim WJ; Division of Cardiology, CHA Bundang Medical Center, Seongnam, South Korea.
  • Kang SH; Division of Cardiology, CHA Bundang Medical Center, Seongnam, South Korea.
  • Park CS; Cardiovascular Center and Cardiology Division, Yeouido St. Mary's Hospital, Seoul, South Korea.
  • Lee BK; Division of Cardiology, Kangwon National University Hospital, Chuncheon, South Korea.
  • Suh JW; Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, South Korea.
  • Choi JW; Division of Cardiology, Eulji General Hospital, Seoul, South Korea.
  • Kim KS; Division of Cardiology, Daegu Catholic University Medical Center, Daegu, South Korea.
  • Lee SN; Division of Cardiology, St. Vincent's Hospital, Suwon, South Korea.
  • Park SJ; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
  • Park DW; Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
Eur Heart J ; 45(9): 653-665, 2024 Mar 01.
Article en En | MEDLINE | ID: mdl-37933514
BACKGROUND AND AIMS: The optimal follow-up surveillance strategy for high-risk diabetic patients with had undergone percutaneous coronary intervention (PCI) remains unknown. METHODS: The POST-PCI (Pragmatic Trial Comparing Symptom-Oriented versus Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention) study was a randomized trial comparing a follow-up strategy of routine functional testing at 1 year vs. standard care alone after high-risk PCI. Randomization was stratified according to diabetes status. The primary outcome was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina at 2 years. RESULTS: Among 1706 randomized patients, participants with diabetes (n = 660, 38.7%) had more frequent comorbidities and a higher prevalence of complex anatomical or procedural characteristics than those without diabetes (n = 1046, 61.3%). Patients with diabetes had a 52% greater risk of primary composite events [hazard ratio (HR) 1.52; 95% confidence interval (CI) 1.02-2.27; P = .039]. The 2-year incidences of the primary composite outcome were similar between strategies of routine functional testing or standard care alone in diabetic patients (7.1% vs. 7.5%; HR 0.94; 95% CI 0.53-1.66; P = .82) and non-diabetic patients (4.6% vs. 5.1%; HR 0.89; 95% CI 0.51-1.55; P = .68) (interaction term for diabetes: P = .91). The incidences of invasive coronary angiography and repeat revascularization after 1 year were higher in the routine functional-testing group than the standard-care group irrespective of diabetes status. CONCLUSIONS: Despite being at higher risk for adverse clinical events, patients with diabetes who had undergone high-risk PCI did not derive incremental benefit from routine surveillance stress testing compared with standard care alone during follow-up.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Intervención Coronaria Percutánea Límite: Humans Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Intervención Coronaria Percutánea Límite: Humans Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Reino Unido