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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: M J
authors.initials: MJ
authors.lastname: Eisenberg
authors.forename: D
authors.initials: D
authors.lastname: Schechter
authors.forename: J
authors.initials: J
authors.lastname: Lefkovits
authors.forename: E
authors.initials: E
authors.lastname: Goudreau
authors.forename: U
authors.initials: U
authors.lastname: Deligonul
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
authors.forename: M
authors.initials: M
authors.lastname: Del Core
authors.forename: R
authors.initials: R
authors.lastname: Duerr
authors.forename: P M
authors.initials: PM
authors.lastname: Garzon
authors.forename: T
authors.initials: T
authors.lastname: Huynh
authors.forename: M
authors.initials: M
authors.lastname: Smilovitch
authors.forename: S
authors.initials: S
authors.lastname: Sedlis
authors.forename: D L
authors.initials: DL
authors.lastname: Brown
authors.forename: D
authors.initials: D
authors.lastname: Brieger
authors.forename: L
authors.initials: L
authors.lastname: Pilote
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006334:Heart Function Tests / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data; D013318:Stroke Volume; D013997:Time Factors