One Year After Percutaneous Coronary Intervention:Coronary Computed Tomographic Angiography Or Conventional Coronary Angiography?

Background:Patients with coronary heart disease need follow-up to rule out possible in-stent restenosis and new atherosclerosis one year after their first percutaneous coronary intervention (PCI). For patients with no marked chest pain, coronary computed tomographic angiography (CCTA) is an alternative strategy for coronary angiography (CAG). However, because results of CCTA are affected by calcification, stents and so on, its usefulness in determine whether patients are safe in the following one year is not well establishment.Methods:It is an open-label, observationally prospective study. We observed and followed up162patients who had PCI and follow-up CCTA (93patients) or CAG (62patients)1year after PCI in our hospital for1year. We compared the rate of cardiovascular events and medical resource utilization between two groups. The outcome was also safety, assessed in the each subgroup of patients with a negative or sever CCTA examination, or with more than two stents. All events and medical resource utilization were collected by telephone during the following1year after follow-up CCTA or CAG.Results:We enrolled162patients (93patients in CCTA group and69patients in CAG group). The baseline characteristics were of no significant difference in the two groups. The patients in each group had no significantly different rate of all-cause death, cardiovascular death and acute coronary syndrome (ACS). Of93patients after follow-up CCTA, none died. As compared with patients receiving conventional CAG, patients in the CCTA group had a lower rate of emergency visit (6.5%vs.17.4%; OR:0.33,95%CI:0.116-0.922, p=0.042), and a higher rate of having CCTA again (31.2%vs.11.6%; OR:3.46,95%CI:1.465-8.146, p=0.004). The patients with more than2stents in each group had similar rate of cardiovascular events and medical resource utilization.Conclusions:A CCTA-based strategy for patients with stents one year after PCI appears to allow the safe, expedited discharge and lower medical cost. CCTA could be an alternative tool for evaluating stenosis in patients and negative results suggest good prognosis in following one year.