Study examines exercise testing in asymptomatic patients after coronary revascularization

Asymptomatic patients who undergo treadmill exercise echocardiography (ExE) after coronary revascularization may be identified as being at high risk but those patients do not appear to have more favorable outcomes with repeated revascularization, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication. The article is part of the journal's Less is More series.

Cardiac events and recurrent ischemia (a temporary shortage of oxygen caused by impaired blood flow; identified in the study as new or worsening cardiac wall motion abnormality shown on the echocardiogram) are common after revascularization procedures, both percutaneous coronary intervention (PCI) and coronary bypass graft surgery (CABG).

Guidelines of the American College of Cardiology/American Heart Association recommend evaluation with stress imaging tests, including ExE, in symptomatic patients after revascularization, but evaluating asymptomatic patients "is more controversial," the authors note in the study background.

"Testing is considered inappropriate early after PCI ( END