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09-05-2024 | Ischemic Heart Disease (D Mukherjee, Section Editor)

Routine Functional Testing or Standard Care in High-Risk Patients after Percutaneous Coronary Intervention

Authors: Nouman Arshad, Indah Sukmawati, Upul Wickramarachchi, Shrilla Banerjee, Fathima Aaysha Cader

Published in: Current Cardiology Reports | Issue 6/2024

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Abstract

Purpose of Review

This review aimed to collate the available evidence on outcomes following routine functional stress testing vs standard of care (i.e. symptom-guided stress testing) in high-risk patients following percutaneous coronary intervention (PCI).

Recent Findings

The most recent pragmatic POST-PCI trial provided randomized evidence showing that routine functional stress testing post-PCI did not lead to a reduction in 2-year ischemic cardiovascular events or all-cause mortality, as compared to a symptom-guided standard-of-care approach. This was also true for sub-analyses including multivessel or left main disease, diabetics, as well as following imaging or physiology guided PCI.

Summary

In the absence of a change in their clinical or functional status suggestive of stent failure, post-PCI routine periodic stress testing in stable patients on guideline-directed medical therapy is currently not recommended by American clinical practice guidelines. While evidence on the cost-effectiveness of routine stress testing strategy is scarce, physician, payer, and policy-level interventions to reduce inappropriate use of routine functional testing need to be addressed.
Literature
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Metadata
Title
Routine Functional Testing or Standard Care in High-Risk Patients after Percutaneous Coronary Intervention
Authors
Nouman Arshad
Indah Sukmawati
Upul Wickramarachchi
Shrilla Banerjee
Fathima Aaysha Cader
Publication date
09-05-2024
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 6/2024
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-024-02064-z

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