An initial invasive strategy did not reduce the risk of ischemic cardiovascular events or all-cause death compared to a conservative strategy over 3.2 years.
Does an initial invasive strategy reduce ischemic cardiovascular events or death from any cause in patients with stable coronary disease and moderate or severe ischemia?
In patients with stable coronary disease and moderate to severe ischemia, an initial invasive strategy does not significantly reduce the risk of ischemic cardiovascular events or death compared to a conservative strategy.
Absolute Event Rate: 0% vs 0%
Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).
“The probability over 5.7 years that a patient's risk of dying is lower with the invasive strategy is nil, which means: Go with the patient's preference. Not undergoing revascularization is a reasonable strategy because there is no excess mortality.”
Landmark trial with long-term follow-up and meta-analyses still shaping PCI vs OMT debates in 2026.
Maron et al. (Mon,) reported a other. An initial invasive strategy did not reduce the risk of ischemic cardiovascular events or all-cause death compared to a conservative strategy over 3.2 years.