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Editor's Note
June 11, 2012

Stress Testing and the Cardiology Top 5: Comment on “Exercise Testing in Asymptomatic Patients After Revascularization”

Arch Intern Med. 2012;172(11):863. doi:10.1001/archinternmed.2012.1955

Stress testing is a common noninvasive test in cardiology. Harb et al point out that routinely repeating these tests in patients who have undergone coronary revascularization can result in additional procedures that can cause harm but do not lead to reduced mortality. The Choosing Wisely campaign of the American Board of Internal Medicine Foundation seeks to identify activities that if done less frequently would result in better patient outcomes. Many professional societies have identified a “Top 5” list of activities that if not done would result in better patient care. “Do not perform serial stress cardiac imaging or advanced noninvasive imaging as part of routine follow-up in asymptomatic patients” is one of the Top 5 recommendations for the American College of Cardiology and also gets a Less Is More designation.