{"id":22575,"date":"2022-10-02T04:25:00","date_gmt":"2022-10-01T20:25:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22575"},"modified":"2022-10-02T07:46:16","modified_gmt":"2022-10-01T23:46:16","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%ab%98%e5%8d%b1%e6%82%a3%e8%80%85pci%e5%90%8e%e5%b8%b8%e8%a7%84%e5%8a%9f%e8%83%bd%e6%a3%80%e6%9f%a5%e6%88%96%e6%a0%87%e5%87%86%e6%b2%bb%e7%96%97","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22575","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u9ad8\u5371\u60a3\u8005PCI\u540e\u5e38\u89c4\u529f\u80fd\u68c0\u67e5\u6216\u6807\u51c6\u6cbb\u7597"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Routine Functional Testing or Standard Care in High-Risk Patients after PCI<\/h1>\n\n\n\n

Duk-Woo Park, Do-Yoon Kang, Jung-Min Ahn,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med August 28, 2022
DOI: 10.1056\/NEJMoa2208335<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

There are limited data from randomized trials to guide a specific follow-up surveillance approach after myocardial revascularization. Whether a follow-up strategy that includes routine functional testing improves clinical outcomes among high-risk patients who have undergone percutaneous coronary intervention (PCI) is uncertain.<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

We randomly assigned 1706 patients with high-risk anatomical or clinical characteristics who had undergone PCI to a follow-up strategy of routine functional testing (nuclear stress testing, exercise electrocardiography, or stress echocardiography) at 1 year after PCI or to standard care alone. The primary outcome was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina at 2 years. Key secondary outcomes included invasive coronary angiography and repeat revascularization.<\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

The mean age of the patients was 64.7 years, 21.0% had left main disease, 43.5% had bifurcation disease, 69.8% had multivessel disease, 70.1% had diffuse long lesions, 38.7% had diabetes, and 96.4% had been treated with drug-eluting stents. At 2 years, a primary-outcome event had occurred in 46 of 849 patients (Kaplan\u2013Meier estimate, 5.5%) in the functional-testing group and in 51 of 857 (Kaplan\u2013Meier estimate, 6.0%) in the standard-care group (hazard ratio, 0.90; 95% confidence interval [CI], 0.61 to 1.35; P=0.62). There were no between-group differences with respect to the components of the primary outcome. At 2 years, 12.3% of the patients in the functional-testing group and 9.3% in the standard-care group had undergone invasive coronary angiography (difference, 2.99 percentage points; 95% CI, \u22120.01 to 5.99), and 8.1% and 5.8% of patients, respectively, had undergone repeat revascularization (difference, 2.23 percentage points; 95% CI, \u22120.22 to 4.68).<\/p>\n\n\n\n

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CONCLUSIONS<\/h2>\n\n\n\n

Among high-risk patients who had undergone PCI, a follow-up strategy of routine functional testing, as compared with standard care alone, did not improve clinical outcomes at 2 years. (Funded by the CardioVascular Research Foundation and Daewoong Pharmaceutical; POST-PCI ClinicalTrials.gov number, NCT03217877. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Routine Functional Testing or Standard […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22575"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22575"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22575\/revisions"}],"predecessor-version":[{"id":22911,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22575\/revisions\/22911"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22575"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22575"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22575"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}