Patients should not undergo stress testing after PCI unless there is a clinical indication for this procedure, the Society for Cardiovascular Angiography and Interventions (SCAI) recommends. SCAI issued a list of procedures that should be avoided in patients with or at risk for cardiovascular disease.

The recommendations are part of the “Choosing Wisely” initiative, which is designed to guide decision making between patients and physicians based on available evidence. SCAI also recommends avoiding the following:

• Coronary angiography after CABG and PCI if patients are asymptomatic or have normal or mildly abnormal stress tests and stable symptoms;
• Coronary angiography to determine risk in patients with stable ischemic heart disease who are unwilling or unable to undergo revascularization;
• Coronary angiography to evaluate risk in patients with no symptoms or evidence of ischemia or other problems based on noninvasive testing; and
• PCI in asymptomatic patients with ischemic heart disease without evidence of ischemia on stress testing or with abnormal fractional flow reserve testing.

These procedures were determined to be “inappropriate” or “rarely appropriate” based on appropriate use criteria or “not recommended” based on current professional guidelines developed by SCAI and other professional societies.

“We believe this list will spur conversations between heart patients and their physicians to make wise decisions about care based on their individual situation,” James C. Blankenship, MD, vice president of SCAI, said in a press release. “Our goal is to improve care for the patient and eliminate unnecessary tests and procedures.”