Saint Luke's Mid America Heart Institute is proud to have played a major role in the largest-ever randomized international trial to compare initial invasive surgical treatment vs. managing with medication and lifestyle changes for stable ischemic heart disease. The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial focused on evaluating survival and benefits to the patients quality of life.
The trial was conducted at 320 sites in 37 countries and followed 5,179 participants with a baseline moderate or severe ischemia for about 3.3 years.
An initial invasive strategy accompanied by optimal medical therapy (OMT) didn’t reduce the risk of cardiovascular death, MI, hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest, compared to a conservative strategy, medication, of OMT alone. The rates at 4 years were 15.5% with the conservative strategy and 13.3% with the invasive strategy.
“In patients with angina, shared decision-making should occur to align treatment with patients’ goals and preferences,” said Dr. John Spertus, director of health outcomes research at Saint Luke's Mid America Heart Institute and co-principal investigator for the ISCHEMIA quality of life analysis.
The study found that while there was no real difference in ultimate survival rates with surgical intervention – there was a significant benefit in terms of quality of life and patient experience. This is considered to be "practice changing" by both interventional cardiologists and non-interventionalists.
Learn more on the ISCHEMIA trial by reading these articles about the trail and findings: