Results for the Ischemia Trials: To Intervene or Not to Intervene
|It is unknown whether a routine invasive approach of cardiac catheterization and revascularization offers incremental value over a conservative approach of optimal medical therapy (OMT), with catheterization reserved for failure of medical therapy in patients with stable ischemic heart disease (SIHD) and moderate or severe ischemia.|
5179 participants were randomized. Participants were 64 years old (median), 23% women, 34% 1726 nonwhite, 16% Hispanic, 41% diabetic, and 90% with a history of angina. The qualifying stress test modality was stress imaging in 3909 (75%); the remainder were nonimaging ETTs. Core laboratories judged that the trial-required level of ischemia was met in 85% of randomized participants. Among the 3912 of 5179 randomized participants who underwent coronary computed tomography angiography, 79% had multivessel CAD and 87% had left anterior descending (LAD) stenosis (proximal in 47%). Primary and secondary clinical outcomes will be presented.
|Hochman JS||American Heart Association, Scientific Sessions, International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes, November 16, 2019|
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