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Randomized Controlled Trial
. 2017 Jan 23;10(2):109-117.
doi: 10.1016/j.jcin.2016.10.018. Epub 2016 Dec 28.

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

Hiroki Shiomi  1 , Takeshi Morimoto  2 , Shoji Kitaguchi  3 , Yoshihisa Nakagawa  4 , Katsuhisa Ishii  5 , Yoshisumi Haruna  3 , Itaru Takamisawa  6 , Makoto Motooka  7 , Kazuhiro Nakao  8 , Shintaro Matsuda  9 , Satoru Mimoto  10 , Yutaka Aoyama  11 , Teruki Takeda  12 , Koichiro Murata  13 , Masaharu Akao  14 , Tsukasa Inada  15 , Hiroshi Eizawa  9 , Eiji Hyakuna  16 , Kojiro Awano  17 , Manabu Shirotani  18 , Yutaka Furukawa  19 , Kazushige Kadota  20 , Katsumi Miyauchi  21 , Masaru Tanaka  15 , Yuichi Noguchi  22 , Sunao Nakamura  10 , Satoshi Yasuda  8 , Shunichi Miyazaki  23 , Hiroyuki Daida  21 , Kazuo Kimura  24 , Yuji Ikari  25 , Haruo Hirayama  11 , Tetsuya Sumiyoshi  6 , Takeshi Kimura  26 ; ReACT Investigators
Collaborators, Affiliations
Free article
Randomized Controlled Trial

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

Hiroki Shiomi et al. JACC Cardiovasc Interv. .
Free article

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).

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