Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

ISCHEMIA-CKD: No benefit for coronary revascularization in advanced CKD with stable angina

Key clinical point: Coronary revascularization provides no clinical or quality of life benefit over optimal medical therapy alone in patients with advanced chronic kidney disease and stable ischemic heart disease, even if their ischemia is severe.

Major finding: The 3-year rates of death or MI were 36.7% in patients randomized to an initial strategy of optimal medical therapy alone and 36.4% in those randomized to an early invasive strategy coupled with optimal medical therapy.

Study details: This was a randomized, multinational clinical trial with up to 4 years of prospective follow-up of 777 patients with advanced CKD and stable coronary disease with moderate or severe ischemia on baseline testing.

Disclosures: The ISCHEMIA-CKD trial was funded by the National Heart, Lung, and Blood Institute. The presenter reported having no relevant financial interests.


Bangalore S. AHA 2019, Late Breaking Science 2 session.