Routine Functional Testing or Standard Care in High-Risk Patients after PCI

This multicenter, randomized trial compared routine functional testing (nuclear stress testing, exercise electrocardiography, or stress echocardiography) with standard care alone in 1706 high-risk patients who had undergone percutaneous coronary intervention (PCI). The primary outcome a composite of death, myocardial infarction, or hospitalization for unstable angina at 2 years—occurred in 5.5% of the functional-testing group and 6.0% of the standard-care group (hazard ratio, 0.90; 95% CI, 0.61–1.35; P=0.62). Routine functional testing did not improve clinical outcomes but was associated with higher rates of invasive coronary angiography (12.3% vs. 9.3%) and repeat revascularization (8.1% vs. 5.8%). The findings suggest that routine stress testing does not reduce ischemic events in high-risk PCI patients and may lead to more invasive procedures without clinical benefit.

This multicenter, randomized trial compared routine functional testing (nuclear stress testing, exercise electrocardiography, or stress echocardiography) with standard care alone in 1706 high-risk patients who had undergone percutaneous coronary intervention (PCI). The primary outcome a composite of death, myocardial infarction, or hospitalization for unstable angina at 2 years—occurred in 5.5% of the functional-testing group and 6.0% of the standard-care group (hazard ratio, 0.90; 95% CI, 0.61–1.35; P=0.62). Routine functional testing did not improve clinical outcomes but was associated with higher rates of invasive coronary angiography (12.3% vs. 9.3%) and repeat revascularization (8.1% vs. 5.8%). The findings suggest that routine stress testing does not reduce ischemic events in high-risk PCI patients and may lead to more invasive procedures without clinical benefit.