Society for Cardiovascular Angiography and Interventions

View all recommendations from this society

Released March 31, 2014

Avoid performing routine stress testing after percutaneous coronary intervention (PCI) without specific clinical indications.

In patients who have undergone successful revascularization with PCI and are now symptom free, routine screening via stress testing can lead to the performance of additional procedures with little clinical benefit. Therefore, testing should generally be limited to patients with changes in clinical status (for example: new symptoms or decreasing exercise tolerance).

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

Members of the SCAI Quality Improvement Committee reviewed the appropriate use criteria for catheterization and percutaneous coronary revascularization, and the guidelines for stable ischemic heart disease and percutaneous coronary revascularization. The Committee extracted this list from these documents, which have been developed by the Society for Cardiovascular Angiography and Interventions, American College of Cardiology Foundation, American Heart Association and other professional societies over the past four years.

Appropriate use criteria grade clinical scenarios as appropriate, uncertain (or sometimes appropriate), or inappropriate (or rarely appropriate) for catheterization or coronary intervention. Guidelines describe circumstances when catheterization or coronary interventions are recommended (Class I), are probably recommended (Class IIa), may be reasonable (Class IIb), or are not recommended (Class III). The items in thisChoosing Wisely® list were selected from among the scenarios rated as inappropriate (or rarely appropriate) by the appropriate use criteria or as Class III (not recommended) by the guidelines. These items were selected (rather than making new items forChoosing Wisely®) because these appropriate use criteria and guidelines have been carefully vetted, adjudicated and agreed upon by myriad experts from many societies.

The proposed Choosing Wisely® items were critiqued by the SCAI Quality Improvement Committee and several authors of documents cited in this list. They were approved by the SCAI Executive Committee. The Committees would like to emphasize that the science of guidelines and appropriate use criteria should be complementary to the art of clinical judgment for best care of the individual patient.

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