In the European Society of Cardiology (ESC) Congress 2022, Dr. Duk-Woo Park from the University of Ulsan College of Medicine, Seoul, Korea, presented the results of his group’s investigation into the effectiveness of routine functional testing as a follow-up strategy after percutaneous coronary intervention (PCI) among high-risk patients.¹

Currently, there were limited data from randomized trials that guided a specific follow-up surveillance approach after coronary revascularization.¹ Though prior studies have reported the widespread use of cardiac stress testing, with more than half of all patients who underwent PCI or coronary artery bypass grafting (CABG) having functional testing within 2 years of revascularization, it is unclear whether such a follow-up strategy could improve the clinical outcomes among high-risk patients who undergo PCI.¹

The POST-PCI trial, a pragmatic, randomized trial, was designed to investigate whether routine stress testing leads to changes in subsequent management and preventive strategies, as well as to study the effects of follow-up strategies with functional testing routines on the reduction of ischemic cardiovascular (CV) events or mortality.¹

In the study, 1,700 high-risk patients who had undergone PCI in real-world clinical practice were eligible and enrolled.1 They underwent stratified randomization by trial center or diabetes, and were randomized 1:1 to conduct routine stress testing at 12 months after PCI or a standard care strategy.¹ The cardiac stress tests included exercise electrocardiography (ECG), nuclear stress imaging, or stress echocardiography.¹ The primary endpoint was the composite of major CV events, including death from any cause, myocardial infarction (MI), or hospitalization for unstable angina (UA), at 2 years after randomization.¹ The key secondary endpoints included invasive coronary angiography and repeat revascularization procedures, while other secondary endpoints included hospitalization for any reason, composite of death or MI, and the individual components of the primary endpoint.¹

The baseline characteristics were consistent across both groups.¹ The mean age was 64.6 years in the functional testing group and 64.8 years in the standard care group.¹ The average