ISCHEMIA Trial: Routine invasive therapy does not reduce MACE

 The ISCHEMIA trial fails at proving that routine invasive therapy was associated with a reduction in major adverse ischemic events compared with optimal medical therapy among stable patients with moderate ischemia. Ischemia is a serious problem where some part of your body, like your heart or brain, isn't getting enough blood. Approximately 1.5 million cases of ischemic myocardial infarction (MI) occur annually in the United States; the yearly incidence rate is approximately 600 cases per 100,000 people.

The routine invasive therapy was compared with optimal medical therapy among patients with stable ischemic heart disease and moderate to severe myocardial ischemia on noninvasive stress testing in the trial. Patients with stable ischemic heart disease and moderate to severe ischemia were randomized to routine invasive therapy included 2,588 participants versus medical therapy had 2,591.

Results in journal American College of Cardiology concluded among patients with stable ischemic heart disease and moderate to severe ischemia on noninvasive stress testing, routine invasive therapy failed to reduce major adverse cardiac events compared with optimal medical therapy. There was possible enhanced benefit for invasive compared with heart failure/left ventricular dysfunction.