Surveillance Stress Testing After Percutaneous Intervention for Patients With Multivessel or Left Main Coronary Disease.
J Am Coll Cardiol
; 83(9): 890-900, 2024 Mar 05.
Article
en En
| MEDLINE
| ID: mdl-38418002
ABSTRACT
BACKGROUND:
The optimal surveillance strategy after percutaneous coronary intervention (PCI) for high-risk patients with multivessel or left main coronary artery disease (CAD) remains uncertain.OBJECTIVES:
This study aims to determine the prognostic role of routine functional testing in patients with multivessel or left main CAD who underwent PCI.METHODS:
The POST-PCI (Pragmatic Trial Comparing Symptom-Oriented Versus Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention) trial randomized high-risk PCI patients to routine functional testing at 1 year or standard care alone during follow-up. This analysis focused on participants with multivessel or left main CAD. The primary outcome was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina at 2 years.RESULTS:
Among 1,706 initially randomized patients, 1,192 patients with multivessel (n = 833) or left main (n = 359) were identified, with 589 in the functional testing group and 603 in the standard care group. Two-year incidences of primary outcome were similar between the functional testing group and the standard care group (6.2% vs 5.7%, respectively; HR 1.09; 95% CI 0.68-1.74; P = 0.73). This trend persisted in both groups of multivessel (6.2% vs 5.7%; HR 1.09; 95% CI 0.62-1.89; P = 0.78) and left main disease (6.2% vs 5.7%; HR 1.09; 95% CI 0.46-2.56; P = 0.85) (P for interaction = 0.90). Routine surveillance functional testing was associated with increased rates of invasive angiography and repeat revascularization beyond 1 year.CONCLUSIONS:
In high-risk patients with multivessel or left main CAD who underwent PCI, there was no incremental clinical benefit from routine surveillance functional-testing compared with standard care alone during follow-up. (Pragmatic Trial Comparing Symptom-Oriented Versus Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention [POST-PCI]; NCT03217877).Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Intervención Coronaria Percutánea
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Infarto del Miocardio
Límite:
Humans
Idioma:
En
Revista:
J Am Coll Cardiol
/
J. Am. Coll. Cardiol
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Journal of the American College of Cardiology
Año:
2024
Tipo del documento:
Article