Routine Functional Testing or Standard Care in High-Risk Patients after Percutaneous Coronary Intervention
Nouman, Arshad Indah, Sukmawati Upul, wickramarachchi Shrilla, Banerjee Aaysha, Cader, Fathima
Nouman, Arshad
Indah, Sukmawati
Upul, wickramarachchi
Shrilla, Banerjee
Aaysha, Cader, Fathima
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. 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.
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Date
2024-06-24
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Arshad N, Sukmawati I, Wickramarachchi U, Banerjee S, Cader FA. Routine Functional Testing or Standard Care in High-Risk Patients after Percutaneous Coronary Intervention. Curr Cardiol Rep. 2024 Jun;26(6):497-503. doi: 10.1007/s11886-024-02064-z. Epub 2024 May 9.