In patients who have no new or worsening symptoms or no prior evidence of silent ischemia and are not at high risk for a recurrent cardiac event, the useful- ness of annual surveillance exercise ECG testing is not well established. (Level of Evidence: C) Class III: No Benefit 1. Nuclear MPI, echocardiography, or CMR, with ei- ther exercise or pharmacological stress or CCTA, is not recommended for follow-up assessment in pa- tients with SIHD, if performed more frequently than at a) 5-year intervals after CABG or b) 2-year intervals after PCI.10,12,15 (Level of Evidence: C) See Online Data Supplement 1 for additional data on nonin- vasive testing in known SIHD: asymptomatic (or stable symptoms). 6.3.3. Factors Influencing the Use of Follow-Up Testing The appropriateness of performing noninvasive testing in patients who either are asymptomatic or have stable symp- toms (ie, routine surveillance testing) depends on factors related to the likelihood of significant findings, such as the patient s risk for rapidly advancing disease, propensity to have silent ischemia, and length of time since revasculariza- tion. The data supporting follow-up testing are sparse and insufficient to support routine, repeat testing in asymptomatic individuals. However, evidence exists that persistent ische- mia on testing is a prognostically poor finding. 