Clinical Implications of Early Exercise Treadmill Testing after Percutaneous Coronary Intervention in the Drug-eluting Stent Era
10.3346/jkms.2020.35.e229
- Author:
Sung Woo CHO
1
;
Jeong Hoon YANG
;
Taek Kyu PARK
;
Joo Myung LEE
;
Young Bin SONG
;
Joo-Yong HAHN
;
Jin-Ho CHOI
;
Hyeon-Cheol GWON
;
Sang Hoon LEE
;
Seung-Hyuk CHOI
Author Information
1. Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2020;35(27):e229-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Limited data are available on the clinical meaning of early routine exercise treadmill testing (ETT) after percutaneous coronary intervention (PCI) in the drug-eluting stent era. We aimed to determine the clinical utility and implications of early routine ETT after PCI.
Methods:This was a single-center, prospective cohort study. A total of 776 patients underwent ETT within 3 months after index PCI were analyzed. We classified patients into ETT positive (+) and negative (−) groups and compared major adverse cardiac events (MACE) including all-cause death, myocardial infarction, and coronary revascularization.
Results:The median follow-up duration was 19.6 months (interquartile range, 15.4 to 33.5 months). ETT was positive for 63 patients (17.1%) with single-vessel disease (VD) and 150 patients (36.9%) with multi-VD. Previous PCI, absence of thrombotic lesion, multi-VD, and residual Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score > 8 were independent predictors of ETT (+). Compared with the ETT (−) group, the ETT (+) group was associated with increased risk of MACE for patients with single-VD (18.1% vs. 52.3%; adjusted hazard ratio [HR], 2.67; 95% confidence interval [CI], 1.10–6.49; P = 0.03) and residual SYNTAX score ≤ 8 (26.5% vs. 42.1%; adjusted HR, 1.90; 95% CI, 1.09–3.30; P = 0.02), but not for patients with multi-VD and residual SYNTAX score > 8.
Conclusion:Early routine ETT after PCI might be helpful for predicting clinical outcomes in patients with single-VD and residual SYNTAX score ≤ 8 but not multi-VD and residual SYNTAX score > 8.
