{"id":29034,"date":"2012-05-15T15:16:34","date_gmt":"2012-05-15T19:16:34","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=29034"},"modified":"2012-05-15T15:16:34","modified_gmt":"2012-05-15T19:16:34","slug":"no-benefit-found-for-exercise-echocardiography-in-asymptomatic-patients-following-cabg-or-pci","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/05\/15\/no-benefit-found-for-exercise-echocardiography-in-asymptomatic-patients-following-cabg-or-pci\/","title":{"rendered":"No Benefit Found for Exercise Echocardiography in Asymptomatic Patients Following CABG Or PCI"},"content":{"rendered":"<p>Routine exercise echocardiography in asymptomatic patients after revascularization does not lead to better outcomes, according to <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1151706\">a new study published in <em>Archives of Internal Medicine<\/em><\/a>. Although guidelines generally discourage the practice, post-revascularization stress tests are still commonly performed.<\/p>\n<p>Serge Harb and colleagues performed exercise echocardiography on 2105 patients after CABG surgery or PCI and followed them for a mean of 5.7 years. Some 13% of the subjects were found to have ischemia; of these, one third underwent repeat revascularization. Nearly half (49%) of the patients without ischemia on the initial test underwent further exercise testing. Overall, 17% of patients in the study underwent repeat revascularization. However, revascularization had no significant impact on mortality.<\/p>\n<p>Mortality was higher in patients who had ischemia at any time than in patients with no ischemia (8% vs. 4.1%, p=0.03). However, the authors reported that &#8220;clinical and stress testing findings, but not echocardiographic features, were associated with both all-cause and cardiac mortality.&#8221; This finding, according to the authors, suggests &#8220;that risk evaluation could be obtained from a standard exercise test rather than exercise echocardiography.&#8221;<\/p>\n<p>The authors write that &#8220;careful consideration is warranted before the screening of asymptomatic patients is considered appropriate at any stage after revascularization.&#8221;<\/p>\n<p>In <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1151589\">an accompanying commentary<\/a>, Mark Eisenberg writes that the study makes &#8220;a compelling argument that routine periodic stress testing in asymptomatic patients following coronary revascularization is of little clinical benefit.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Routine exercise echocardiography in asymptomatic patients after revascularization does not lead to better outcomes, according to a new study published in Archives of Internal Medicine. Although guidelines generally discourage the practice, post-revascularization stress tests are still commonly performed. Serge Harb and colleagues performed exercise echocardiography on 2105 patients after CABG surgery or PCI and followed [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,20,9],"tags":[231,1274,301,827,1275],"class_list":["post-29034","post","type-post","status-publish","format-standard","hentry","category-cardiac-imaging","category-cardiac-surgery","category-interventional-cardiology","tag-cabg","tag-exercise-echocardiography","tag-pci","tag-revascularization","tag-stress-testing"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29034","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=29034"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29034\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=29034"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=29034"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=29034"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}