Medication on Par with Early Invasive Treatment for Stable IHD

An international randomized trial revealed that an initial invasive approach compared to optimal medical therapy (OMT) in stable ischemic heart disease (SIHD) patients with moderate-severe ischemia did not reduce risk of cardiovascular disease (CVD) end points at a median of 3.3 years. The trial enrolled 5179 SIHD patients with moderate-severe ischemia in 37 countries, median age 64 years old. The curves cross for the primary endpoint (CV death, non-fatal myocardial infarction [MI], resuscitated cardiac arrest, hospitalization for unstable angina, or heart failure) and the major secondary endpoint (CV death, MI) at approximately 2 years from randomization, with an absolute 1.9% more events in the first 6 months and 2.2% fewer at 4 years compared with OMT. Procedural MIs were increased (early risk) while spontaneous MIs were reduced (later benefit) with an invasive strategy. Similar findings were also revealed in a trial of 777 patients with advanced chronic kidney disease and moderate or severe ischemia. The results are consistent with previous studies. Source: https://www.medpagetoday.com/