Vandan Upadhyaya1, Smitha Narayana Gowda2, Gustavo Porto3, Chirag P Bavishi4, Partha Sardar5, Riyaz Bashir6, Mustafa Emir Gokceer7, Saurav Chatterjee8. 1. Division of Cardiology, Jersey Shore Medical Center, Neptune, NJ, USA. 2. Division of Cardiology, Houston Methodist Hospital, Houston, TX, USA. 3. Frank H Netter School of Medicine, Quinnipiac University, Hamden, CT, USA. 4. Division of Cardiology, University of Missouri Columbia, Columbia, MO, USA. 5. Division of Cardiology, Ochsner Clinic, New Orleans, LA, USA. 6. Division of Cardiology, Temple University Hospitals, Philadelphia, PA, USA. 7. Dokuz Eylul University Faculty of Medicine.Izmir, Anatolia, Turkey. 8. Division of Cardiovascular Medicine, Long Island Jewish Medical Center, 270-05 76th Street, New Hyde Park, NY, 11040, USA. sauravchatterjeemd@gmail.com.
Abstract
PURPOSE OF REVIEW: The ISCHEMIA trial demonstrated no difference in myocardial infarction or death in patients with stable coronary disease and moderate or large ischemia territory treated either with invasive revascularization or optimal medical therapy. Whether the findings of the randomized control trial relates to real-world outcomes is uncertain. RECENT FINDINGS: Contemporary guideline-directed medical therapy has had a significant impact on the prognosis of coronary artery disease. Various observational data appear to indicate limited generalizability of the ISCHEMIA trial in different populations. Further studies are warranted to evaluate the optimal modality of therapy in patients with stable coronary disease and moderate or severe ischemia. The applicability of ISCHEMIA and ISCHEMIA-CKD trials still requires further validation.
PURPOSE OF REVIEW: The ISCHEMIA trial demonstrated no difference in myocardial infarction or death in patients with stable coronary disease and moderate or large ischemia territory treated either with invasive revascularization or optimal medical therapy. Whether the findings of the randomized control trial relates to real-world outcomes is uncertain. RECENT FINDINGS: Contemporary guideline-directed medical therapy has had a significant impact on the prognosis of coronary artery disease. Various observational data appear to indicate limited generalizability of the ISCHEMIA trial in different populations. Further studies are warranted to evaluate the optimal modality of therapy in patients with stable coronary disease and moderate or severe ischemia. The applicability of ISCHEMIA and ISCHEMIA-CKD trials still requires further validation.
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