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How Frequently Should A Stress Test Be Done After Putting Stent?
Question: After having a stent put in will a stress test be every six months, yearly or will there comes a time I wont have to have them? Is this a life time issue?
Brief Answer:
explained
Detailed Answer:
Hello and Welcome
I appreciate your concern.
Longer-term issues post-PCI are very patient-specific and variable . Initially the six month stress will be performed, the subsequent testing duration will depend upon your response to the revascularization , if improved then a longer interval before the next test.
The efficacy and safety of coronary stenting seemed to be clinically sustained at 7 to 11 years of follow-up. However, late luminal re narrowing beyond 4 years was common, which demonstrates the need for further follow-up, so yes a life long follow up is done but the duration is increased if the patient is stable and re narrowing doesn't exceed.
Post PCI , in the long term ,broadly involves detection and treatment of recurrent ischemia, arrhythmias and heart failure, appropriate antiplatelet therapy and secondary prevention
Although about 10% of PCI patients who have bare metal stents (BMSs) have asymptomatic restenosis, there are no data to suggest that universal routine stress testing post-PCI improves outcome. However, it is reasonable to perform routine stress testing around 6 months post-PCI in selected cases where there is a high risk of restenosis affecting a large myocardial territory as recommended by the XXXXXXX College of Cardiology (ACC)/American Heart Association (AHA) guidelines. It is also useful to determine the physiological significance of an intermediate stenosis in another vessel before further PCI is contemplated. As exercise testing is an insensitive predictor of restenosis (with only 50% sensitivity),stress testing complemented with non-invasive myocardial imaging giving superior sensitivity [echo, nuclear perfusion or magnetic resonance imaging (MRI)] is sometimes required in these patients
Routine follow-up angiography is only indicated in very few selected cases. These include patients who have received left main coronary artery stenting where repeat angiography can be performed in 3-9 months
Let me know if you have any query
wishing you best of health
Thanks
explained
Detailed Answer:
Hello and Welcome
I appreciate your concern.
Longer-term issues post-PCI are very patient-specific and variable . Initially the six month stress will be performed, the subsequent testing duration will depend upon your response to the revascularization , if improved then a longer interval before the next test.
The efficacy and safety of coronary stenting seemed to be clinically sustained at 7 to 11 years of follow-up. However, late luminal re narrowing beyond 4 years was common, which demonstrates the need for further follow-up, so yes a life long follow up is done but the duration is increased if the patient is stable and re narrowing doesn't exceed.
Post PCI , in the long term ,broadly involves detection and treatment of recurrent ischemia, arrhythmias and heart failure, appropriate antiplatelet therapy and secondary prevention
Although about 10% of PCI patients who have bare metal stents (BMSs) have asymptomatic restenosis, there are no data to suggest that universal routine stress testing post-PCI improves outcome. However, it is reasonable to perform routine stress testing around 6 months post-PCI in selected cases where there is a high risk of restenosis affecting a large myocardial territory as recommended by the XXXXXXX College of Cardiology (ACC)/American Heart Association (AHA) guidelines. It is also useful to determine the physiological significance of an intermediate stenosis in another vessel before further PCI is contemplated. As exercise testing is an insensitive predictor of restenosis (with only 50% sensitivity),stress testing complemented with non-invasive myocardial imaging giving superior sensitivity [echo, nuclear perfusion or magnetic resonance imaging (MRI)] is sometimes required in these patients
Routine follow-up angiography is only indicated in very few selected cases. These include patients who have received left main coronary artery stenting where repeat angiography can be performed in 3-9 months
Let me know if you have any query
wishing you best of health
Thanks
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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