ISCHEMIA Trial: Key Questions and Answers

A healthy lifestyle, myocardial revascularisation and medical therapy constitute the three pillars for the treatment of ischaemic heart disease. Lifestyle and optimal medical therapy should be used in all cases. However, the selection of cases for revascularisation among stable patients remains cont...

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Autores principales:	Jose Lopez-Sendon, Raúl Moreno, Juan Tamargo
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/6a790b6fe6724bd686a4c8c31e303ba9
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id	oai:doaj.org-article:6a790b6fe6724bd686a4c8c31e303ba9
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spelling	oai:doaj.org-article:6a790b6fe6724bd686a4c8c31e303ba92021-12-04T16:04:58ZISCHEMIA Trial: Key Questions and Answers10.15420/ecr.2021.161758-37641758-3756https://doaj.org/article/6a790b6fe6724bd686a4c8c31e303ba92021-09-01T00:00:00Zhttps://www.ecrjournal.com/articleindex/ecr.2021.16https://doaj.org/toc/1758-3756https://doaj.org/toc/1758-3764A healthy lifestyle, myocardial revascularisation and medical therapy constitute the three pillars for the treatment of ischaemic heart disease. Lifestyle and optimal medical therapy should be used in all cases. However, the selection of cases for revascularisation among stable patients remains controversial. The ISCHEMIA trial compared an early invasive strategy with revascularisation plus optimal medical therapy against initial optimal medical therapy alone with revascularisation reserved for cases in which symptom control was insufficient. The study included over 5,000 patients with stable coronary artery disease and moderate to severe myocardial ischaemia. No differences were found in relevant clinical outcomes, including all-cause mortality, cardiovascular death, MI, heart failure and stroke, over a follow-up of 3.2 years. Conversely, angina control was better in patients with severe symptomatic angina. Following the tradition of all trials comparing medical therapy alone with revascularisation, the ISCHEMIA trial results are controversial, but an analysis of the design and results of the trial offers important information to better understand, evaluate and treat the growing number of patients with stable chronic ischaemic heart disease and moderate to severe myocardial ischaemia.Jose Lopez-SendonRaúl MorenoJuan TamargoRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENEuropean Cardiology Review , Vol 16, Iss , Pp - (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Jose Lopez-Sendon Raúl Moreno Juan Tamargo ISCHEMIA Trial: Key Questions and Answers
description	A healthy lifestyle, myocardial revascularisation and medical therapy constitute the three pillars for the treatment of ischaemic heart disease. Lifestyle and optimal medical therapy should be used in all cases. However, the selection of cases for revascularisation among stable patients remains controversial. The ISCHEMIA trial compared an early invasive strategy with revascularisation plus optimal medical therapy against initial optimal medical therapy alone with revascularisation reserved for cases in which symptom control was insufficient. The study included over 5,000 patients with stable coronary artery disease and moderate to severe myocardial ischaemia. No differences were found in relevant clinical outcomes, including all-cause mortality, cardiovascular death, MI, heart failure and stroke, over a follow-up of 3.2 years. Conversely, angina control was better in patients with severe symptomatic angina. Following the tradition of all trials comparing medical therapy alone with revascularisation, the ISCHEMIA trial results are controversial, but an analysis of the design and results of the trial offers important information to better understand, evaluate and treat the growing number of patients with stable chronic ischaemic heart disease and moderate to severe myocardial ischaemia.
format	article
author	Jose Lopez-Sendon Raúl Moreno Juan Tamargo
author_facet	Jose Lopez-Sendon Raúl Moreno Juan Tamargo
author_sort	Jose Lopez-Sendon
title	ISCHEMIA Trial: Key Questions and Answers
title_short	ISCHEMIA Trial: Key Questions and Answers
title_full	ISCHEMIA Trial: Key Questions and Answers
title_fullStr	ISCHEMIA Trial: Key Questions and Answers
title_full_unstemmed	ISCHEMIA Trial: Key Questions and Answers
title_sort	ischemia trial: key questions and answers
publisher	Radcliffe Medical Media
publishDate	2021
url	https://doaj.org/article/6a790b6fe6724bd686a4c8c31e303ba9
work_keys_str_mv	AT joselopezsendon ischemiatrialkeyquestionsandanswers AT raulmoreno ischemiatrialkeyquestionsandanswers AT juantamargo ischemiatrialkeyquestionsandanswers
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ISCHEMIA Trial: Key Questions and Answers

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