{"id":"06b467182422","type":"article","url":"https://hartvaat.nl/2024/03/01/post-pci-routine-stresstesten-bij-diabetespatienten-na-pci-niet-zinvol/","title":"POST-PCI: routine stresstesten bij diabetespatiënten na PCI niet zinvol","title_en":"Routine stress testing in diabetic patients after percutaneous coronary intervention: the POST-PCI trial.","category":"preventie","category_label":"Preventie","professions":["cardioloog","internist"],"tags":["soul-trial"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehad722","source_url":"https://doi.org/10.1093/eurheartj/ehad722","authors":["Hoyun Kim","Do-Yoon Kang","Jinho Lee","Yeonwoo Choi","Jung-Min Ahn","Seonok Kim","Yong-Hoon Yoon","Seung-Ho Hur","Cheol Hyun Lee","Won-Jang Kim","Se Hun Kang","Chul Soo Park","Bong-Ki Lee","Jung-Won Suh","Jae Woong Choi","Kee-Sik Kim","Su Nam Lee","Seung-Jung Park","Duk-Woo Park"],"significance":7,"published":"2024-03-01","source_date":"2024-03-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/ezetimib/","https://hartvaat.nl/kennis/lipiden/bempedoïnezuur/"],"congress":"","summary_en":"The POST-PCI trial confirmed that routine stress testing in diabetic patients after PCI does not improve clinical outcomes compared with a symptom-guided approach, arguing against surveillance testing even in this high-risk population.","created":"2026-07-03T10:30:48Z","updated":"2026-07-03T13:29:51Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De POST-PCI trial toonde dat routinematige stresstesten bij diabetespatiënten na PCI geen klinisch voordeel bieden. Een symptoomgeleide follow-up is even veilig en kosteneffectiever.","abstract_original":"BACKGROUND AND AIMS: The optimal follow-up surveillance strategy for high-risk diabetic patients with had undergone percutaneous coronary intervention (PCI) remains unknown. METHODS: The POST-PCI (Pragmatic Trial Comparing Symptom-Oriented versus Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention) study was a randomized trial comparing a follow-up strategy of routine functional testing at 1 year vs. standard care alone after high-risk PCI. Randomization was stratified according to diabetes status. The primary outcome was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina at 2 years. RESULTS: Among 1706 randomized patients, participants with diabetes (n = 660, 38.7%) had more frequent comorbidities and a higher prevalence of complex anatomical or procedural characteristics than those without diabetes (n = 1046, 61.3%). Patients with diabetes had a 52% greater risk of primary composite events [hazard ratio (HR) 1.52; 95% confidence interval (CI) 1.02-2.27; P = .039]. The 2-year incidences of the primary composite outcome were similar between strategies of routine functional testing or standard care alone in diabetic patients (7.1% vs. 7.5%; HR 0.94; 95% CI 0.53-1.66; P = .82) and non-diabetic patients (4.6% vs. 5.1%; HR 0.89; 95% CI 0.51-1.55; P = .68) (interaction term for diabetes: P = .91). The incidences of invasive coronary angiography and repeat revascularization after 1 year were higher in the routine functional-testing group than the standard-care group irrespective of diabetes status. CONCLUSIONS: Despite being at higher risk for adverse clinical events, patients with diabetes who had undergone high-risk PCI did not derive incremental benefit from routine surveillance stress testing compared with standard care alone during follow-up."}