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

  • Ischemic Heart Disease (D Mukherjee, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

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.

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Author information

Authors and Affiliations

  1. Frank H. Netter, MD School of Medicine, Quinnipiac University, North Haven, CT, USA

    Jamal Choudhary

  2. Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA

    Sarah Chiu

  3. Department of Internal Medicine, Houston Methodist Hospital, Houston, TX, USA

    Priyanka Bhugra

  4. Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Behnood Bikdeli

  5. Yale/YNHH Center for Outcomes Research & Evaluation, New Haven, CT, USA

    Behnood Bikdeli

  6. Cardiovascular Research Foundation (CRF), New York, NY, USA

    Behnood Bikdeli

  7. South Shore University Hospital, Northwell Health, Zucker School of Medicine, New York, NY, USA

    Azhar Supariwala

  8. Sandra Atlas Bass Heart Hospital, Manhasset, NY, 11030, USA

    Rajiv Jauhar

  9. North Shore University Hospita, Manhasset, NY, 11030, USA

    Rajiv Jauhar

  10. Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA

    Rajiv Jauhar

  11. Division of Cardiovascular Medicine, Long Island Jewish Medical Center, Northwell Health, Zucker School of Medicine, 270-05 76th Street, New Hyde Park, New York, NY, USA

    Saurav Chatterjee

Authors
  1. Jamal Choudhary
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  2. Sarah Chiu
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  3. Priyanka Bhugra
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  4. Behnood Bikdeli
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  5. Azhar Supariwala
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Correspondence to Saurav Chatterjee.

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This article is part of the Topical Collection on Ischemic Heart Disease

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Choudhary, J., Chiu, S., Bhugra, P. et al. Clinical Implications of the ISCHEMIA Trial: Invasive vs Conservative Approach in Stable Coronary Disease. Curr Cardiol Rep 23, 43 (2021). https://doi.org/10.1007/s11886-021-01470-x

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  • DOI: https://doi.org/10.1007/s11886-021-01470-x

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