Background: Although randomized clinical trials are valuable tools to compare treatment effects, the results of randomized clinical trials cannot usually be extrapolated to the real-world setting because of selected patient subsets. To categorize the risk of future cardiovascular events in drug-eluting stent (DES)-treated patients, we analyzed demographic, clinical, and procedural data in all-comers who underwent a percutaneous coronary intervention (PCI).
Methods: Patients who underwent PCI using DES from January 2004 were prospectively enrolled in the Catholic University of Korea-PCI registry and were followed up for a median of 2 years. We analyzed the risk of clinical outcomes in the all-patient cohort and in subsets of patients with angina and acute myocardial infarction (AMI).
Results: The patients were categorized into two groups: those with angina (angina group, n=6183, 67.7%) and those with AMI (AMI group, n=2944, 32.3%). The AMI group had greater occurrence of major adverse cardiac events (MACE) during long-term follow-up than the angina group (23.8 vs. 20.1%, P<0.001). However, in the landmark analysis of data beyond 1 year, there was no significant difference in the occurrence of MACE between the two groups (P=0.44). In multivariable modeling, age, renal function, left ventricular ejection fraction, and multivessel disease were associated significantly with increasing MACE in the study population, angina or AMI groups.
Conclusion: We found that higher MACE in patients with AMI during long-term follow-up after PCI was mainly because of higher mortality in the first year. Some demographic, clinical, and angiographic factors still significantly influence the long-term occurrence of MACE in the era of DES.