Clinical Edge

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ISCHEMIA trial revisited: Some MAY benefit from invasive strategy

Key clinical point: An initial invasive approach may be beneficial in patients with stable coronary artery disease, moderate to severe ischemia, and a history of heart failure and left ventricular dysfunction.

Major finding: The composite major adverse cardiovascular event rate during 4 years of follow-up of ISCHEMIA trial participants with a baseline history of heart failure symptoms and an left ventricular ejection fraction of 35%-45% was 17.2% if they were randomized to an initial invasive strategy, compared with 29.3% with an initial conservative approach.

Study details: This was a prespecified subgroup analysis of 398 participants in the prospective, randomized ISCHEMIA trial.

Disclosures: The ISCHEMIA trial was funded primarily by the National Heart, Lung, and Blood Institute. The presenter reported having no financial conflicts regarding his presentation.


Lopes R et al. Circulation. 2020 Aug 29. doi: 10.1161/CIRCULATIONAHA.120.050304.