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Complete Revascularization Analysis of ISCHEMIA Opens Pandora s Box

May 18, 2021 Patients with stable coronary artery disease who received “complete” revascularization in the ISCHEMIA trial appear to have derived more clinical benefit with the invasive strategy than medical therapy over follow-up, a finding at odds with what was observed for the overall trial. The implication, say investigators, is that revascularization might offer clinical advantages over conservative medical therapy if all anatomically relevant lesions are treated. This analysis, which focused only on the patients who had complete revascularization defined anatomically, showed that the primary composite endpoint occurred in 11.9% of patients treated invasively as opposed to 15.4% of patients who were treated medically.

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