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KMID : 0191120200350270229
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Journal of Korean Medical Science
2020 Volume.35 No. 27 p.229 ~ p.229
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Clinical Implications of Early Exercise Treadmill Testing after Percutaneous Coronary Intervention in the Drug-eluting Stent Era
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Cho Sung-Woo
Yang Jeong-Hoon
Park Taek-Kyu
Lee Joo-Myung
Song Young-Bin
Hahn Joo-Yong
Choi Jin-Ho
Gwon Hyeon-Cheol
Lee Sang-Hoon
Choi Seung-Hyuk
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Abstract
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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.
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KEYWORD
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Exercise Treadmill Testing, Percutaneous Coronary Intervention
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