A recent study published in the Journal of American Medical Association has shed light on the management of patients with acute coronary syndrome (ACS) who have undergone high-risk percutaneous coronary intervention (PCI). The study revealed that routine stress testing 12 months post-procedure does not offer additional benefits over standard care.

The POST-PCI trial, which compared routine functional testing follow-up strategies with standard care alone, was conducted on patients selected from 11 different sites in South Korea between November 2017 and September 2019. Data analysis in 2022 showed that routine stress testing after high-risk PCI did not result in improved clinical outcomes compared to standard care without routine testing.

The primary measure of the study was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina within two years following randomization. The hazard ratio (HR) for the primary outcome in ACS patients was 1.55, indicating an elevated risk that emphasizes the need for effective follow-up for this patient group.

The study found that the mean age of the patient population was 64.7 years, with 20.5% of the patients being female. Out of 1706 patients, 30.8% had ACS upon presentation, and these patients had a 55% higher risk of the main outcome compared to those without ACS due to increased first-year incident rates.

Interestingly, the 2-year occurrences of the main outcome were similar in individuals with ACS and those without ACS, regardless of whether they underwent regular functional testing or standard therapy alone. Despite some studies suggesting higher rates of invasive angiography and repeat revascularization in the regular functional testing group after one year, the formal relationships among ACS status and these procedures were not significant.

In conclusion, the study highlighted that routine stress testing after high-risk PCI at 12 months did not provide any additional benefit over standard care for ACS patients. This finding is crucial for the management and follow-up of patients who have undergone such procedures.