Exercise Testing in Asymptomatic Patients After Revascularization: Worth the Effort?
Exercise echocardiography in asymptomatic patients after revascularization can identify those at high risk, but these patients do not necessarily benefit from repeat revascularization, according to a retrospective study in the Archives of Internal Medicine.
Researchers studied some 2100 asymptomatic patients who underwent exercise echocardiography roughly 4 years after percutaneous coronary intervention or coronary artery bypass grafting. Of 13% of patients with ischemia on exercise testing, one third had a subsequent revascularization during nearly 6 years of follow-up. While patients with ischemia had a greater mortality risk, repeat revascularization of these patients did not improve survival.
A commentator points out that “routine periodic stress testing in asymptomatic patients following coronary revascularization is associated with high rates of resource utilization and high costs.” He concludes: “Until well-supported data become available supporting such a strategy, routine testing in asymptomatic patients is probably not worth the effort.”
Source: Archives of Internal Medicine.