Clinical Implications of the ISCHEMIA Trial: Invasive vs Conservative Approach in Stable Coronary Disease

Jamal Choudhary; Sarah Chiu; Priyanka Bhugra; Behnood Bikdeli; Azhar Supariwala; Rajiv Jauhar; Saurav Chatterjee

doi:10.1007/s11886-021-01470-x

Clinical Implications of the ISCHEMIA Trial: Invasive vs Conservative Approach in Stable Coronary Disease

Jamal Choudhary, Sarah Chiu, Priyanka Bhugra, Behnood Bikdeli, Azhar Supariwala, Rajiv Jauhar, Saurav Chatterjee

Research output: Contribution to journal › Review article › peer-review

2 Scopus citations

Abstract

Purpose of Review: To identify key strengths and weaknesses of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and explore its clinical implications in patients with stable ischemic heart disease. Recent Findings: Previous studies have shown inconsistent benefit of early angiography and revascularization in patients with stable ischemic heart disease. The ISCHEMIA trial showed no significant reduction in mortality or cardiovascular outcomes in patients undergoing early angiography and revascularization with guideline-directed medical therapy compared to patients on medical therapy alone in specific patient population with stable coronary artery disease. Summary: The ISCHEMIA trial provides insights into invasive versus pharmacological treatment for patients with stable ischemic heart disease. Though it may have reduced applicability given its broad exclusion criteria, it offers useful information about the utility of non-invasive imaging modalities for selecting optimal revascularization candidates.

Original language	English (US)
Article number	43
Journal	Current Cardiology Reports
Volume	23
Issue number	5
DOIs	https://doi.org/10.1007/s11886-021-01470-x
State	Published - May 2021

Keywords

Cardiac catheterization
Guideline-directed medical therapy
Ischemic heart disease
Revascularization

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1007/s11886-021-01470-x

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title = "Clinical Implications of the ISCHEMIA Trial: Invasive vs Conservative Approach in Stable Coronary Disease",

abstract = "Purpose of Review: To identify key strengths and weaknesses of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and explore its clinical implications in patients with stable ischemic heart disease. Recent Findings: Previous studies have shown inconsistent benefit of early angiography and revascularization in patients with stable ischemic heart disease. The ISCHEMIA trial showed no significant reduction in mortality or cardiovascular outcomes in patients undergoing early angiography and revascularization with guideline-directed medical therapy compared to patients on medical therapy alone in specific patient population with stable coronary artery disease. Summary: The ISCHEMIA trial provides insights into invasive versus pharmacological treatment for patients with stable ischemic heart disease. Though it may have reduced applicability given its broad exclusion criteria, it offers useful information about the utility of non-invasive imaging modalities for selecting optimal revascularization candidates.",

keywords = "Cardiac catheterization, Guideline-directed medical therapy, Ischemic heart disease, Revascularization",

author = "Jamal Choudhary and Sarah Chiu and Priyanka Bhugra and Behnood Bikdeli and Azhar Supariwala and Rajiv Jauhar and Saurav Chatterjee",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.",

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doi = "10.1007/s11886-021-01470-x",

language = "English (US)",

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AU - Choudhary, Jamal

AU - Chiu, Sarah

AU - Bhugra, Priyanka

AU - Bikdeli, Behnood

AU - Supariwala, Azhar

AU - Jauhar, Rajiv

AU - Chatterjee, Saurav

PY - 2021/5

Y1 - 2021/5

N2 - Purpose of Review: To identify key strengths and weaknesses of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and explore its clinical implications in patients with stable ischemic heart disease. Recent Findings: Previous studies have shown inconsistent benefit of early angiography and revascularization in patients with stable ischemic heart disease. The ISCHEMIA trial showed no significant reduction in mortality or cardiovascular outcomes in patients undergoing early angiography and revascularization with guideline-directed medical therapy compared to patients on medical therapy alone in specific patient population with stable coronary artery disease. Summary: The ISCHEMIA trial provides insights into invasive versus pharmacological treatment for patients with stable ischemic heart disease. Though it may have reduced applicability given its broad exclusion criteria, it offers useful information about the utility of non-invasive imaging modalities for selecting optimal revascularization candidates.

AB - Purpose of Review: To identify key strengths and weaknesses of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and explore its clinical implications in patients with stable ischemic heart disease. Recent Findings: Previous studies have shown inconsistent benefit of early angiography and revascularization in patients with stable ischemic heart disease. The ISCHEMIA trial showed no significant reduction in mortality or cardiovascular outcomes in patients undergoing early angiography and revascularization with guideline-directed medical therapy compared to patients on medical therapy alone in specific patient population with stable coronary artery disease. Summary: The ISCHEMIA trial provides insights into invasive versus pharmacological treatment for patients with stable ischemic heart disease. Though it may have reduced applicability given its broad exclusion criteria, it offers useful information about the utility of non-invasive imaging modalities for selecting optimal revascularization candidates.

KW - Cardiac catheterization

KW - Guideline-directed medical therapy

KW - Ischemic heart disease

KW - Revascularization

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Clinical Implications of the ISCHEMIA Trial: Invasive vs Conservative Approach in Stable Coronary Disease

Abstract

Keywords

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