Role of routine surveillance stress testing in patients with or without imaging-guided or physiology-guided PCI.
Yeonwoo Choi, Do-Yoon Kang, Hoyun Kim et al.
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In 30 seconds
This randomized controlled trial evaluated the impact of routine surveillance stress testing on clinical outcomes in 1706 high-risk patients post-percutaneous coronary intervention (PCI), comparing those guided by intravascular ultrasonography (IVUS) or fractional flow reserve (FFR). The study found no significant difference in the composite outcome of death, myocardial infarction, or hospitalization for unstable angina at 2 years between routine testing and standard care.
Key findings
- At 2 years, the primary outcome occurred in 5.3% of IVUS-guided patients with routine testing vs 6.7% without.
- In patients without IVUS guidance, the primary outcome was 5.7% with routine testing vs 3.8% without.
- Routine functional testing led to higher rates of invasive coronary angiography and repeat revascularisation.
- No clinical benefit was observed from routine surveillance stress testing after PCI.
Why it matters
The findings suggest that routine surveillance stress testing in high-risk PCI patients does not improve clinical outcomes and may lead to unnecessary invasive procedures, aligning with current guidelines against such practices.