Survival After Initial Stress Testing vs Anatomic Testing in Suspected Coronary Artery Disease

Does choice of initial noninvasive testing modality for coronary artery disease (CAD) affect long-term mortality?In this 10-year follow-up of participants in the PROMISE randomized clinical trial with stable new-onset symptoms suggestive of CAD, rates for all-cause and cardiovascular death did not differ between patients randomized to coronary computed tomographic angiography (CTA) or stress testing for initial testing. Any degree of abnormality on CTA (including nonobstructive disease) was associated with worse outcomes than normal scan results, whereas only severe abnormalities differentiated outcomes with stress testing.This study found that noninvasive testing modality choice for patients with suspected CAD did not affect long-term mortality.

Corresponding Author: Pamela S. Douglas, MD, Duke Clinical Research Institute, Duke University School of Medicine, 300 W Morgan St, Room 841, Durham, NC 27701 (pamela.douglas@duke.edu).

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