Invasive vs. Conservative Strategy for Stable Coronary Disease

In two randomized trials, an invasive strategy did not significantly lower mortality or incidence of myocardial infarction.

Whether coronary revascularization — added to optimal medical therapy — improves outcomes among patients with stable coronary artery disease (CAD) has not been examined in recent randomized trials. Now, the ISCHEMIA trial addresses this issue.

The trial included nearly 5200 patients who had stable CAD and stress testing that showed moderate-to-severe reversible ischemia (on imaging) or severe ischemia (on exercise testing without imaging). Most patients had undergone coronary computed tomography to rule out left main stenosis (patients with left main stenosis were excluded). Patients were randomized to an invasive strategy (medical therapy plus coronary angiography, followed by stenting or bypass surgery, if feasible) or to medical therapy a…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Invasive vs. Conservative Strategy for Stable Coronary Disease

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Reviewing Author