"Importantly, patients identified as high risk did not have more favorable outcomes if they had repeat revascularization," Marwick said.
The researchers concluded that a routine stress test that evaluates exercise capacity is sufficient to identify at-risk patients.
Standard stress tests involve monitoring a patient's blood pressure during exercise.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, commented that "there has been increased interest in whether the used of stress testing in asymptomatic patients with coronary artery disease after revascularization procedures can detect individuals at increased risk of subsequent events and be used to improve clinical outcomes."
This new study showed that in patients without symptoms, exercise echocardiographic stress testing did identify patients both early and late after revascularization at double the risk of dying, he said.
"Given that this testing provides independent prognostic information, further studies are needed to determine whether the findings from this testing is or is not useful for improving clinical outcomes," Fonarow said.
Stress testing combined with imaging can cost between $800 and $2,400 per test. "So, determining the comparative effectiveness of managing asymptomatic patients with or without stress testing is of considerable importance," he said.
The U.S. National Heart, Lung, and Blood Institute has more about types of stress testing.
SOURCES: Thomas H. Marwick, M.D., Ph.D., M.P.H., Cleveland Clinic, Ohio; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; May 14, 2012, Archives of Internal Medicine, online
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