Guidelines for Regular Checkups After Heart Stent Placement Are Changing

Seoul Asan Hospital Heart Center Publishes 8th NEJM Paper
Analysis of Cardiac Stress Function Test Validity After High-Risk Patient Procedures
"Testing Based on Symptoms More Efficient Than Universal Screening"
European Society of Cardiology Announces 'Research of the Year'

Professor Park Deok-woo of the Department of Cardiology at Seoul Asan Medical Center is presenting at the European Society of Cardiology conference held in Barcelona, Spain, on the 28th (local time).

[Asia Economy Reporter Lee Gwan-ju] Domestic researchers have produced research results that will rewrite heart textbooks worldwide. They verified the effectiveness of cardiac stress function tests, which were commonly performed one year after coronary artery stent procedures, and it is expected that future guidelines will reflect not performing these tests routinely.

The cardiology team of Professors Park Deok-woo, Park Seung-jung, and Kang Do-yoon at Seoul Asan Medical Center announced on the 29th that their study compared the incidence of major cardiac events and mortality rates among high-risk patients based on whether regular stress function tests were conducted after coronary intervention, finding no significant difference between the two patient groups. This study was published in the latest issue of the 'NEJM (New England Journal of Medicine),' a clinical treatment textbook for doctors worldwide.

Coronary intervention is a treatment method that inserts a coronary artery stent into narrowed or blocked coronary arteries supplying blood to the heart to widen the vessels. It is the most commonly performed standard treatment for patients with coronary artery diseases such as angina or myocardial infarction. Over the past 20 years, high-risk patients who received stent procedures have regularly undergone stress function tests such as exercise stress tests, cardiac nuclear medicine tests, and pharmacologic stress echocardiography as follow-up examinations to prevent stent restenosis or ischemic heart disease caused by insufficient blood supply to the heart.

This study overturned the conventional wisdom regarding these regular tests. For a public interest prospective multicenter clinical study, the research team randomly assigned 1,706 high-risk patients who underwent coronary intervention at 11 domestic hospitals into two groups: 849 patients who underwent stress function tests one year after the procedure and 857 patients who received only standard treatment without regular check-ups. As a result, the incidence of major clinical events in the group that underwent regular stress function tests was 5.5% at two years post-procedure, while it was 6.0% in the group without regular check-ups, showing no statistically significant difference between the two groups.

From the left, Professors Park Deok-woo, Park Seung-jung, and Kang Do-yoon of the Department of Cardiology, Asan Medical Center, Seoul.

Accordingly, the research team concluded that for high-risk patients who underwent coronary intervention, it is more appropriate for the healthcare system to perform stress function tests not routinely one year after the procedure but only when symptoms such as chest pain, dyspnea, or other suspected recurrences occur, and that this approach does not compromise patient safety.

Professor Park Deok-woo explained, “This paper is the first large-scale randomized clinical study to evaluate the effectiveness of routine stress function tests after coronary intervention, which had been based on experience. It has significant public interest in minimizing tests with uncertain clinical evidence and will directly impact actual patient care.”

This study was presented as the ‘Notable Research of the Year’ at the European Society of Cardiology (ESC) held in Barcelona, Spain, on the 28th (local time) and was simultaneously published online in NEJM.

NEJM has an impact factor (I.F) of 176.079, reflecting its status as the most authoritative clinical journal that greatly influences treatment guidelines for practicing clinicians. With this publication, the total number of NEJM papers authored or co-authored by Seoul Asan Medical Center’s Heart Hospital medical staff has reached eight. Led by Professor Park Seung-jung, who published the first NEJM paper from Korea in 2003, the coronary intervention team treating coronary artery disease has published six papers, and Professor Kang Deok-hyun, who treats valvular heart disease, has published two papers.

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