Routine functional testing after percutaneous coronary intervention

Eisenberg, Mark J.; Wilson, Brooke E; Lauzon, Claude; Huynh, Thao; Eisenhauer, Michael D.; Mak, Koon Hou; Blankenship, James C.; Doucet, Michel; Pilote, Louise

doi:10.2143/ac.62.2.2020234

Cited by 19 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The initial data from the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) registry evidenced that routine functional testing after percutaneous transluminal coronary angioplasty is associated with reduced frequency of follow-up clinical events, including acute coronary syndrome (ACS) and death [ 26 ]. Similar findings have been reported both by Babapulle et al [ 27 ] and Eisenberg et al [ 28 ]. More recently, Cho et al [ 29 ] investigated the role of early exercise stress testing in patients with single- or multivessel disease, demonstrating that early assessment after PCI might be helpful for predicting clinical outcomes in subjects with single-vessel disease and residual SYNTAX score ≤ 8.…”

Section: Discussionsupporting

confidence: 92%

Prognostic Impact of a Routine Six-Month Exercise Stress Test after Complex Left Main Bifurcation Percutaneous Intervention

Rigatelli,

Zuin,

Marchese

et al. 2023

Diagnostics

View full text Add to dashboard Cite

The prognostic value of exercise stress test after complex left main (LM) coronary artery bifurcation (LM) stenting has been poorly investigated. To partially fill this gap in knowledge, we retrospectively analyzed the procedural and medical data of consecutive patients referred to our center for complex LM bifurcation disease between January 2008 and May 2018 who were treated using either single- or dual-stenting techniques. The prognostic impact of an exercise stress test, performed 6 months after the coronary intervention, was evaluated in 502 patients (316 males, mean age 70.3 ± 12.8 years, mean Syntax score 31.6 ± 6.3). At follow up after a mean of 37.1 ± 10.8 months (range 22.1–47.3 months), the target lesion failure (TLF) rate was 10.1% while stent thrombosis and cardiovascular mortality were 1.2 and 3.6%, respectively. A positive exercise stress test was detected at 6-month follow up in 42 out of 502 patients (8.4%); the incidence of a significant restenosis was 7.6% (n = 38). Patients with a negative exercise stress test at 6-month follow up had higher freedom from TLF and improved survival compared to those with a positive exercise stress test.

show abstract

Section: Discussionsupporting

confidence: 92%

Prognostic Impact of a Routine Six-Month Exercise Stress Test after Complex Left Main Bifurcation Percutaneous Intervention

Rigatelli,

Zuin,

Marchese

et al. 2023

Diagnostics

View full text Add to dashboard Cite

show abstract

“…[3][4][5][6][7][8] Although generic quality-of-life assessments (such as the SF-36) have been used, disease-specific instruments such as the Seattle Angina Questionnaire (SAQ) have been shown to be more sensitive in fully capturing patient-centered health status among patients with coronary artery disease. 9,10 Although the SAQ has previously been shown to be associated with mortality and morbidity in patients with chronic coronary artery disease, 11,12 the magnitude of the association between persistent angina and both future resource utilization and costs has not been described.…”

mentioning

confidence: 99%

Economic Impact of Angina After an Acute Coronary Syndrome

Arnold

Morrow

Lei

et al. 2009

Circ: Cardiovascular Quality and Outcomes

110

View full text Add to dashboard Cite

Background-Angina in patients with coronary artery disease is associated with worse quality of life; however, the relationship between angina frequency and resource utilization is unknown. Methods and Results-Using data from the MERLIN-TIMI 36 trial, we assessed the association between the extent of angina after an acute coronary syndrome (ACS) and subsequent cardiovascular resource utilization among 5460 stable outpatients who completed the Seattle Angina Questionnaire at 4 months after an ACS and who were then followed for an additional 8 months. Angina frequency was categorized as none (score, 100; 2739 patients), monthly (score, 61 to 99; 1608 patients), weekly (score, 31 to 60; 854 patients), and daily (score, 0 to 30; 259 patients). Multivariable regression models evaluated the association between angina frequency and overall costs attributable to cardiovascular hospitalizations, outpatient visits and procedures, and medications. As compared with no angina, overall costs increased in a graded fashion with higher angina frequency-no angina, $2928 (reference); monthly angina, $3909 (adjusted relative cost ratio, 1.29; 95% CI, 1.21 to 1.39); weekly angina, $4558 (adjusted relative cost ratio, 1.52; 95% CI, 1.48 to 1.67); and daily angina, $6949 (adjusted relative cost ratio, 2.32; 95% CI, 2.01 to 2.69; P for trend Ͻ0.001). Differences in costs were attributable primarily to higher rates of ACS hospitalization and coronary revascularization among patients with more severe angina. Conclusion-Among stable outpatients after ACS, a direct graded relationship was found between higher angina frequency and healthcare costs. As compared with patients without angina, patients with daily angina had a Ͼ2-fold increase in resource utilization and incremental costs of $4000 after 8 months of follow-up.

show abstract

“… 4 Other studies showed controversial results on the usefulness of early routine ETT and stress imaging tests after PCI for predicting clinical outcomes. 5 6 7 8 9 10 Therefore, we aimed to investigate the clinical utility and implications of early routine ETT. We compared clinical outcomes between ETT positive (+) and ETT negative (−) according to the presence of multi-VD and residual Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score in post-PCI patients from a single-center prospective registry.…”

Section: Introductionmentioning

confidence: 99%

Clinical Implications of Early Exercise Treadmill Testing after Percutaneous Coronary Intervention in the Drug-eluting Stent Era

et al. 2020

View full text Add to dashboard Cite

Background: Limited data are available on the clinical meaning of early routine exercise treadmill testing (ETT) after percutaneous coronary intervention (PCI) in the drug-eluting stent era. We aimed to determine the clinical utility and implications of early routine ETT after PCI. Methods: This was a single-center, prospective cohort study. A total of 776 patients underwent ETT within 3 months after index PCI were analyzed. We classified patients into ETT positive (+) and negative (−) groups and compared major adverse cardiac events (MACE) including all-cause death, myocardial infarction, and coronary revascularization. Results: The median follow-up duration was 19.6 months (interquartile range, 15.4 to 33.5 months). ETT was positive for 63 patients (17.1%) with single-vessel disease (VD) and 150 patients (36.9%) with multi-VD. Previous PCI, absence of thrombotic lesion, multi-VD, and residual Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score > 8 were independent predictors of ETT (+). Compared with the ETT (−) group, the ETT (+) group was associated with increased risk of MACE for patients with single-VD (18.1% vs. 52.3%; adjusted hazard ratio [HR], 2.67; 95% confidence interval [CI], 1.10-6.49; P = 0.03) and residual SYNTAX score ≤ 8 (26.5% vs. 42.1%; adjusted HR, 1.90; 95% CI, 1.09-3.30; P = 0.02), but not for patients with multi-VD and residual SYNTAX score > 8. Conclusion: Early routine ETT after PCI might be helpful for predicting clinical outcomes in patients with single-VD and residual SYNTAX score ≤ 8 but not multi-VD and residual SYNTAX score > 8.

show abstract

Routine functional testing after percutaneous coronary intervention

Abstract: Routine functional testing following PCI in high-risk patients may lead to improved exercise endurance but not improved QOL.

Cited by 19 publications

References 0 publications

Prognostic Impact of a Routine Six-Month Exercise Stress Test after Complex Left Main Bifurcation Percutaneous Intervention

Prognostic Impact of a Routine Six-Month Exercise Stress Test after Complex Left Main Bifurcation Percutaneous Intervention

Economic Impact of Angina After an Acute Coronary Syndrome

Clinical Implications of Early Exercise Treadmill Testing after Percutaneous Coronary Intervention in the Drug-eluting Stent Era

Contact Info

Product

Resources

About