Use of routine functional testing after percutaneous transluminal coronary angioplasty: Results from the ROSETTA registry

Mark J. Eisenberg, David Schechter, Jeffrey Lefkovits, Evelyne Goudreau, Ubeydullah Deligonul, Koon Hou Mak, Michael Del Core, Robert Duerr, Philippe M. Garzon, Thao Huynh, Mark Smilovitch, Steven Sedlis, David L. Brown, David Brieger, Louise Pilote

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for exercise testing suggest that only selected groups of high-risk patients should undergo routine functional testing after percutaneous transluminal coronary angioplasty (PTCA) for the detection of restenosis. Objectives. Our purpose was (1) to document the patterns of use of post-PTCA functional testing and (2) to determine whether the choice of functional testing strategy is related to clinical characteristics of patients or whether physicians use a similar strategy for all their patients. Methods. The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) Registry is a prospective study examining the use of functional testing among 788 patients at 13 centers in 5 countries. Results. During the 6-month period after a successful PTCA, 49% of patients underwent functional testing (range among centers 10%-81%). Among patients who underwent functional testing, 39% had a clinical indication and 61% had functional testing as a routine follow-up. The first functional test was performed a median of 7 weeks after PTCA, with 13% of patients having second tests at a median of 14 weeks and 4% having additional tests at a median of 20 weeks. Univariate and multivariate analyses demonstrated that the chief determinant of the use of routine functional testing was clinical center. Aside from age (P <.0001), no baseline clinical or procedural characteristics were consistently associated with the use of routine functional testing after PTCA. Conclusions. Physicians do not appear to be adhering to the ACC/AHA guidelines for exercise testing regarding the routine use of post-PTCA functional testing. None of the clinical characteristics identified by the ACC/AHA guidelines were associated with the routine use of post-PTCA functional testing, and the primary determinant of functional testing was the location of the center at which the patient had the PTCA.

Original languageEnglish
Pages (from-to)837-846
Number of pages10
JournalAmerican Heart Journal
Volume141
Issue number5
DOIs
StatePublished - 2001

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Coronary Balloon Angioplasty
Angioplasty
Registries
Exercise
American Heart Association
Guidelines
Cardiology
Physicians
Multivariate Analysis
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Eisenberg, M. J., Schechter, D., Lefkovits, J., Goudreau, E., Deligonul, U., Mak, K. H., ... Pilote, L. (2001). Use of routine functional testing after percutaneous transluminal coronary angioplasty: Results from the ROSETTA registry. American Heart Journal, 141(5), 837-846. https://doi.org/10.1067/mhj.2001.114373

Use of routine functional testing after percutaneous transluminal coronary angioplasty : Results from the ROSETTA registry. / Eisenberg, Mark J.; Schechter, David; Lefkovits, Jeffrey; Goudreau, Evelyne; Deligonul, Ubeydullah; Mak, Koon Hou; Del Core, Michael; Duerr, Robert; Garzon, Philippe M.; Huynh, Thao; Smilovitch, Mark; Sedlis, Steven; Brown, David L.; Brieger, David; Pilote, Louise.

In: American Heart Journal, Vol. 141, No. 5, 2001, p. 837-846.

Research output: Contribution to journalArticle

Eisenberg, MJ, Schechter, D, Lefkovits, J, Goudreau, E, Deligonul, U, Mak, KH, Del Core, M, Duerr, R, Garzon, PM, Huynh, T, Smilovitch, M, Sedlis, S, Brown, DL, Brieger, D & Pilote, L 2001, 'Use of routine functional testing after percutaneous transluminal coronary angioplasty: Results from the ROSETTA registry', American Heart Journal, vol. 141, no. 5, pp. 837-846. https://doi.org/10.1067/mhj.2001.114373
Eisenberg, Mark J. ; Schechter, David ; Lefkovits, Jeffrey ; Goudreau, Evelyne ; Deligonul, Ubeydullah ; Mak, Koon Hou ; Del Core, Michael ; Duerr, Robert ; Garzon, Philippe M. ; Huynh, Thao ; Smilovitch, Mark ; Sedlis, Steven ; Brown, David L. ; Brieger, David ; Pilote, Louise. / Use of routine functional testing after percutaneous transluminal coronary angioplasty : Results from the ROSETTA registry. In: American Heart Journal. 2001 ; Vol. 141, No. 5. pp. 837-846.
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title = "Use of routine functional testing after percutaneous transluminal coronary angioplasty: Results from the ROSETTA registry",
abstract = "Background. The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for exercise testing suggest that only selected groups of high-risk patients should undergo routine functional testing after percutaneous transluminal coronary angioplasty (PTCA) for the detection of restenosis. Objectives. Our purpose was (1) to document the patterns of use of post-PTCA functional testing and (2) to determine whether the choice of functional testing strategy is related to clinical characteristics of patients or whether physicians use a similar strategy for all their patients. Methods. The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) Registry is a prospective study examining the use of functional testing among 788 patients at 13 centers in 5 countries. Results. During the 6-month period after a successful PTCA, 49{\%} of patients underwent functional testing (range among centers 10{\%}-81{\%}). Among patients who underwent functional testing, 39{\%} had a clinical indication and 61{\%} had functional testing as a routine follow-up. The first functional test was performed a median of 7 weeks after PTCA, with 13{\%} of patients having second tests at a median of 14 weeks and 4{\%} having additional tests at a median of 20 weeks. Univariate and multivariate analyses demonstrated that the chief determinant of the use of routine functional testing was clinical center. Aside from age (P <.0001), no baseline clinical or procedural characteristics were consistently associated with the use of routine functional testing after PTCA. Conclusions. Physicians do not appear to be adhering to the ACC/AHA guidelines for exercise testing regarding the routine use of post-PTCA functional testing. None of the clinical characteristics identified by the ACC/AHA guidelines were associated with the routine use of post-PTCA functional testing, and the primary determinant of functional testing was the location of the center at which the patient had the PTCA.",
author = "Eisenberg, {Mark J.} and David Schechter and Jeffrey Lefkovits and Evelyne Goudreau and Ubeydullah Deligonul and Mak, {Koon Hou} and {Del Core}, Michael and Robert Duerr and Garzon, {Philippe M.} and Thao Huynh and Mark Smilovitch and Steven Sedlis and Brown, {David L.} and David Brieger and Louise Pilote",
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T1 - Use of routine functional testing after percutaneous transluminal coronary angioplasty

T2 - Results from the ROSETTA registry

AU - Eisenberg, Mark J.

AU - Schechter, David

AU - Lefkovits, Jeffrey

AU - Goudreau, Evelyne

AU - Deligonul, Ubeydullah

AU - Mak, Koon Hou

AU - Del Core, Michael

AU - Duerr, Robert

AU - Garzon, Philippe M.

AU - Huynh, Thao

AU - Smilovitch, Mark

AU - Sedlis, Steven

AU - Brown, David L.

AU - Brieger, David

AU - Pilote, Louise

PY - 2001

Y1 - 2001

N2 - Background. The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for exercise testing suggest that only selected groups of high-risk patients should undergo routine functional testing after percutaneous transluminal coronary angioplasty (PTCA) for the detection of restenosis. Objectives. Our purpose was (1) to document the patterns of use of post-PTCA functional testing and (2) to determine whether the choice of functional testing strategy is related to clinical characteristics of patients or whether physicians use a similar strategy for all their patients. Methods. The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) Registry is a prospective study examining the use of functional testing among 788 patients at 13 centers in 5 countries. Results. During the 6-month period after a successful PTCA, 49% of patients underwent functional testing (range among centers 10%-81%). Among patients who underwent functional testing, 39% had a clinical indication and 61% had functional testing as a routine follow-up. The first functional test was performed a median of 7 weeks after PTCA, with 13% of patients having second tests at a median of 14 weeks and 4% having additional tests at a median of 20 weeks. Univariate and multivariate analyses demonstrated that the chief determinant of the use of routine functional testing was clinical center. Aside from age (P <.0001), no baseline clinical or procedural characteristics were consistently associated with the use of routine functional testing after PTCA. Conclusions. Physicians do not appear to be adhering to the ACC/AHA guidelines for exercise testing regarding the routine use of post-PTCA functional testing. None of the clinical characteristics identified by the ACC/AHA guidelines were associated with the routine use of post-PTCA functional testing, and the primary determinant of functional testing was the location of the center at which the patient had the PTCA.

AB - Background. The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for exercise testing suggest that only selected groups of high-risk patients should undergo routine functional testing after percutaneous transluminal coronary angioplasty (PTCA) for the detection of restenosis. Objectives. Our purpose was (1) to document the patterns of use of post-PTCA functional testing and (2) to determine whether the choice of functional testing strategy is related to clinical characteristics of patients or whether physicians use a similar strategy for all their patients. Methods. The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) Registry is a prospective study examining the use of functional testing among 788 patients at 13 centers in 5 countries. Results. During the 6-month period after a successful PTCA, 49% of patients underwent functional testing (range among centers 10%-81%). Among patients who underwent functional testing, 39% had a clinical indication and 61% had functional testing as a routine follow-up. The first functional test was performed a median of 7 weeks after PTCA, with 13% of patients having second tests at a median of 14 weeks and 4% having additional tests at a median of 20 weeks. Univariate and multivariate analyses demonstrated that the chief determinant of the use of routine functional testing was clinical center. Aside from age (P <.0001), no baseline clinical or procedural characteristics were consistently associated with the use of routine functional testing after PTCA. Conclusions. Physicians do not appear to be adhering to the ACC/AHA guidelines for exercise testing regarding the routine use of post-PTCA functional testing. None of the clinical characteristics identified by the ACC/AHA guidelines were associated with the routine use of post-PTCA functional testing, and the primary determinant of functional testing was the location of the center at which the patient had the PTCA.

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