Role of routine surveillance stress testing in patients with or without imaging-guided or physiology-guided percutaneous coronary intervention (PCI)
Authors' conclusion
Among high-risk patients who underwent PCI, routine surveillance stress testing did not reduce the risk of death, myocardial infarction or unstable angina, regardless of the use of IVUS or FFR at the index procedure. Routine functional testing increased downstream invasive procedures without clinical benefit. These findings support guideline recommendations against routine surveillance testing after PCI.
Study context
- Population
- High-risk patients who underwent PCI, categorised by use of intravascular ultrasonography (IVUS) or fractional flow reserve (FFR) at the index procedurehigh-risk patients who underwent PCI
- Participants
- 1,706 patients
- Comparison
- Routine functional testing at 1 year or standard care alone
- Primary endpoint
- Composite of:
- Death
- Myocardial infarction
- Hospitalisation for unstable angina
- Follow-up
- 2 years
Methodological detailsrandomised trial
- Randomised trial
Primary result
As reported in the abstract
routine testing vs standard careHazard ratio (95% CI)
IVUS guidance: 5.3% vs 6.7%
0.79(0.50–1.24)
Without IVUS guidance: 5.7% vs 3.8%
1.52(0.63–3.68)
FFR guidance: 2.6% vs 3.9%
0.65(0.26–1.58)
Without FFR guidance: 7.0% vs 7.1%
0.99(0.63–1.55)
Further findings
Invasive coronary angiography and repeat revascularisation
- Routine functional testing consistently associated with higher use of invasive coronary angiography and repeat revascularisation, without improvement in clinical outcomes
Use of IVUS and FFR guidance
- IVUS-guided intervention
- 74%
- FFR-guided intervention
- 36%
Original publication
Role of routine surveillance stress testing in patients with or without imaging-guided or physiology-guided PCI. Heart. Published 2 October 2025. doi:10.
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