Stress Testing Common in Years After Revascularization

Most PCI, CABG patients have cardiac stress test within two years; repeat revascularization rate low
By Eric Metcalf
HealthDay Reporter

FRIDAY, Oct. 8 (HealthDay News) -- The majority of patients undergoing coronary revascularization are likely to have a stress test in the following two years, with relatively few requiring repeat revascularization, according to research published in the Oct. 12 issue of the Journal of the American College of Cardiology.

Bimal R. Shah, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues analyzed data from 28,177 patients who underwent revascularization, with roughly three-fourths having percutaneous coronary intervention (PCI) procedures and the remainder having coronary artery bypass grafting (CABG) procedures.

The researchers found that 61 percent of those who'd had PCI, as well as 51 percent of patients with CABG, had undergone stress testing by 24 months. Nuclear imaging was the most commonly used testing method. Testing was found to increase at six and 12 months after revascularization, suggesting that testing was related to elective follow-up office visits. Only 11 and 5 percent underwent subsequent catheterization or repeat revascularization, respectively.

"The study by Shah et al, despite its limitations as a retrospective analysis of insurance claims, highlights the high and probably excessive use of stress testing in the first year after revascularization, with marked regional variation in test use. This study serves as another wake-up call to cardiovascular specialists to be more diligent in adhering to evidence-based practice guidelines and appropriate use criteria," writes the author of an accompanying editorial.

Three co-authors disclosed employment or grant support from UnitedHealthCare.

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