ISCHEMIA Trial: Key Questions and Answers.
Myocardial ischaemia
coronary artery bypass grafting
myocardial revascularisation
optimal medical therapy
percutaneous coronary intervention
stable angina
stable coronary artery disease
Journal
European cardiology
ISSN: 1758-3764
Titre abrégé: Eur Cardiol
Pays: England
ID NLM: 101574780
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
28
04
2021
accepted:
26
07
2021
entrez:
4
10
2021
pubmed:
5
10
2021
medline:
5
10
2021
Statut:
epublish
Résumé
A healthy lifestyle, myocardial revascularisation and medical therapy constitute the three pillars for the treatment of ischaemic heart disease. Lifestyle and optimal medical therapy should be used in all cases. However, the selection of cases for revascularisation among stable patients remains controversial. The ISCHEMIA trial compared an early invasive strategy with revascularisation plus optimal medical therapy against initial optimal medical therapy alone with revascularisation reserved for cases in which symptom control was insufficient. The study included over 5,000 patients with stable coronary artery disease and moderate to severe myocardial ischaemia. No differences were found in relevant clinical outcomes, including all-cause mortality, cardiovascular death, MI, heart failure and stroke, over a follow-up of 3.2 years. Conversely, angina control was better in patients with severe symptomatic angina. Following the tradition of all trials comparing medical therapy alone with revascularisation, the ISCHEMIA trial results are controversial, but an analysis of the design and results of the trial offers important information to better understand, evaluate and treat the growing number of patients with stable chronic ischaemic heart disease and moderate to severe myocardial ischaemia.
Identifiants
pubmed: 34603514
doi: 10.15420/ecr.2021.16
pmc: PMC8477173
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e34Informations de copyright
Copyright © 2021, Radcliffe Cardiology.
Déclaration de conflit d'intérêts
Disclosure: JT is a Section Editor for European Cardiology Review; this did not affect peer review. All other authors have no conflicts of interest to declare.
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