Routine Stress Testing for Patients with Stable Coronary Artery Disease?

Although current guidelines recommend stress testing to determine the extent of myocardial ischemia in patients with angina, routine testing is not recommended for asymptomatic patients. Prior research findings have suggested that ischemia detected by stress testing influences prognosis, both in symptomatic and in asymptomatic patients. These investigators compared the relative prognostic importance of stress-induced ischemia in patients with established coronary artery disease with and without angina.

Of 937 patients (83% male; mean age, 67) previously diagnosed with CAD who underwent exercise stress echocardiography, stress-induced myocardial ischemia was present in 228, among whom 82% reported no or infrequent angina. Overall, 169 patient…