Routine Stress Testing After Percutaneous Coronary Intervention (PCI) in Patients With and Without Acute Coronary Syndrome: A Secondary Analysis of the POST-PCI Randomized Clinical Trial
Authors' conclusion
Despite being at higher risk for adverse clinical events in the first year after PCI than patients without ACS, patients with ACS who had undergone high-risk PCI did not derive incremental benefit from routine surveillance stress testing at 12 months compared with standard care alone during follow-up.
Study context
- Population
- Patients who had undergone high-risk PCI, with or without acute coronary syndrome (ACS), South Korea526 (30.8%) with ACS
- Participants
- 1,706 patients
- Comparison
- Routine functional testing vs standard care alone 12 months after high-risk PCI, in patients with and without ACS
- Primary endpoint
- Composite of:
- All-cause death
- MI
- Hospitalization for unstable angina
- Follow-up
- 2 years after randomization
Methodological detailsmulticentre, 11 sites in South Korea, subgroup analysis by ACS status, Enrolment November 2017 through September 2019; analysis 2022
- Multicentre
- 11 sites in South Korea
- Subgroup analysis by ACS status
- Enrolment November 2017 through September 2019; analysis 2022
Primary result
As reported in the abstract
Primary outcome by ACS status (subgroups) · 2 years
Functional testing vs Standard careHazard ratio (95% CI)P value
ACS
0.76(0.40–1.44)
P = 0.39No ACS
1.04(0.62–1.74)
P = 0.88Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Primary outcome, ACSvs no ACSDue to higher event rates in the first year | 1.55 (1.03–2.33) | P = 0.03 | |
| 0.512Hazard ratio (log scale) |
Invasive angiography and repeat revascularization · after 1 year (landmark)
- Landmark analysis suggested higher rates with routine functional testing; interactions with ACS status not significant
Original publication
Routine Stress Testing After PCI in Patients With and Without Acute Coronary Syndrome: A Secondary Analysis of the POST-PCI Randomized Clinical Trial. JAMA Cardiol. Published 1 September 2024. doi:10.
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