An Invasive Strategy May Aid Some Patients with Stable Ischemic Heart Disease and Heart Failure

An initial invasive strategy seemed to benefit patients with HF and a left ventricular ejection fraction of 35% to 45%, per a prespecified subanalysis from ISCHEMIA.

The ISCHEMIA trial (NCT01471522) enrolled patients with moderate-to-severe ischemia and a left ventricular ejection fraction (LVEF) >35%. The findings showed no significant advantage of an initial invasive strategy, compared with medical therapy alone, in the primary outcome of cardiovascular death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure (HF), or resuscitated cardiac arrest (NEJM JW Cardiol May 2020 and N Engl J Med 2020; 382:1395). A prespecified subgroup analysis has now focused on the 398 ISCHEMIA participants (7.7%) who had HF, LV systolic dysfunction (LVEF, 35%–45%), or both at baseline. Only 28 participants (0.6%) had both prior HF and LV systolic dysfunction.

Incidence of the primary outc…

Reviewing Author

Fatima Rodriguez, MD, MPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardNovoNordisk; HealthPals; Novartis; Amgen

EquityHealthPals; Carta

Grant/Research SupportNational Institutes of Health/National Heart, Lung, and Blood Institute; American Heart Association–Robert Wood Johnson Foundation

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