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

  • Ischemic Heart Disease (D Mukherjee, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

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.

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Data Availability

No datasets were generated or analysed during the current study.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Kettering General Hospital, Rothwell Road, Kettering, NN16 8UZ, UK

    Nouman Arshad & Fathima Aaysha Cader

  2. Siloam Hospitals Lippo Village - Universitas Pelita Harapan, Tangerang, Indonesia

    Indah Sukmawati

  3. Lanka Hospitals, Colombo, Sri Lanka

    Upul Wickramarachchi

  4. Faculty of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

    Upul Wickramarachchi

  5. Surrey and Sussex Healthcare NHS Trust, Redhill, RH1 5RH, UK

    Shrilla Banerjee

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  5. Fathima Aaysha Cader
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Contributions

N.A., I.S. and F.A.C. wrote the main manuscript text and I.S. prepared Table 1. U.W., S.B. and F.A.C. made critical revisions to the final manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Fathima Aaysha Cader.

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Conflict of Interest

Dr. N Arshad is a Regional Trainee Representative, East Midlands, for the British Junior Cardiologists Association (BJCA). Dr FA Cader is a member of the SCAI Women in Innovations, International and Bifurcation Club Committees, the ACC NCDR CathPCI Research and Publications Committee, and the AHA QCOR Early Career Committee. Dr I Sukmawati has received speaker fees from AstraZeneca and Novartis; has received the Interventional Cardiology Fellowships Training Grant from Chien Foundation; and is the Secretary for the Women Cardiology Task Force of Indonesian Heart Association. Dr U Wickramarachchi has received travel grants from Bbraun, George Stuart Sri Lanka, Hemas Pharmaceuticals Sri Lanka, and AstraZeneca; and has received speaker fees from Sanofi. Dr S Banerjee has received speaker fees from Menarini, Abbott, Boston Scientific, and Shockwave;, travel grants to PCR (2023) from SMT; and is on advisory board of Boehringer Ingelheim.

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No animal or human subjects by the authors were used in this study.

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Arshad, N., Sukmawati, I., Wickramarachchi, U. et al. Routine Functional Testing or Standard Care in High-Risk Patients after Percutaneous Coronary Intervention. Curr Cardiol Rep (2024). https://doi.org/10.1007/s11886-024-02064-z

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  • DOI: https://doi.org/10.1007/s11886-024-02064-z

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