ISCHEMIA Trial – Review

ISCHEMIA Trial – Review International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial was funded by National Heart, Lung, and Blood Institute and others. 5179 patients with moderate or severe ischemia was randomized to an initial invasive strategy or an initial conservative strategy. Initial invasive strategy was angiography and revascularization when feasible. Initial conservative therapy was of medical treatment alone and angiography if medical therapy failed [1]. Primary composite outcome included death from cardiovascular causes, myocardial infarction or hospitalization for unstable angina, heart failure or resuscitated cardiac arrest. 318 primary outcome events in the invasive strategy group and 352 primary outcome events in the conservative strategy group occurred over a median follow up period of 3.2 years. Cumulative event rates at 6 months were 5.3% and 3.4% in the two groups. At 5 years, the cumulative event rates were 16.4% in the invasive group and 18.2% in the conservative group. 145 deaths occurred in the invasive strategy group and 144 deaths in the conservative strategy group. Authors concluded that among patients with stable coronary artery disease and moderate or severe ischemia, there was no evidence that early invasive strategy reduced the risk of ischemic cardiovascular events or all cause mortality over the study period. Enrollment in the study was after clinically indicated stress testing showed mod...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Coronary Interventions Source Type: blogs