New to MyHealth?
Manage Your Care From Anywhere.
Access your health information from any device with MyHealth. You can message your clinic, view lab results, schedule an appointment, and pay your bill.
ALREADY HAVE AN ACCESS CODE?
DON'T HAVE AN ACCESS CODE?
NEED MORE DETAILS?
MyHealth for Mobile
Impact of Complete Revascularization inthe ISCHEMIA Trial.
Impact of Complete Revascularization inthe ISCHEMIA Trial. Journal of the American College of Cardiology Stone, G. W., Ali, Z. A., O'Brien, S. M., Rhodes, G., Genereux, P., Bangalore, S., Mavromatis, K., Horst, J., Dressler, O., Poh, K. K., Nath, R. K., Moorthy, N., Witkowski, A., Dwivedi, S. K., Bockeria, O., Chen, J., Smanio, P. E., Picard, M. H., Chaitman, B. R., Berman, D. S., Shaw, L. J., Boden, W. E., White, H. D., Fremes, S. E., Rosenberg, Y., Reynolds, H. R., Spertus, J. A., Hochman, J. S., Maron, D. J., ISCHEMIA Research Group, Boden, W., Harrington, R., Williams, D., Alexander, K. P., Berger, J., Mark, D., Ballantyne, C., Beyar, R., Bhargava, B., Buller, C., Carvalho, A. T., Diaz, R., Doerr, R., Dzavik, V., Goodman, S., Gosselin, G., Hachamovitch, R., Hamm, C., Held, C., Helm, M., Huber, K., Jiang, L., Keltai, M., Kohsaka, S., Lang, I., Lopes, R., Lopez-Sendon, J., Maggioni, A., Mancini, J., Bairey Merz, C. N., Min, J., Peterson, E., Ruzyllo, W., Selvanayagam, J., Senior, R., Sharir, T., Steg, G., Szwed, H., Van de Werf, F., Weintraub, W., White, H., Calfas, K., Champagne, M. A., Davidson, M., Fleg, J., McCullough, P. A., Newman, J., Stone, P., Menasche, P., Davidson, M., Fremes, S., Guyton, R., Mack, M., Mohr, F., Rao, A., Sabik, J., Shapira, O., Taggart, D., Tatoulis, J., Blankenship, J., Brener, S., Buller, C., Colombo, A., de Bruyne, B., Kereiakes, D., Lefevre, T., Moses, J., Alexander, K. P., Mahaffey, K., White, H., Cruz-Flores, S., Danchin, N., Feen, E., Garcia, M. J., Hauptman, P., Laddu, A. A., Passamani, E., Pina, I. L., Simoons, M., Skali, H., Thygesen, K., Waters, D., Alexander, K. P., Endsley, P., Esposito, G., Kanters, J., Pownall, J., Stournaras, D., Friedrich, M., Hachamovitch, R., Kwong, R., Mancini, J., Min, J., Oliver, D., Harrell, F., Blume, J., Lee, K., Held, C., Kullo, I., McManus, B., Newby, K., Cohen, D., Weintraub, W., Bairey Merz, C. N., Bugiardini, R., Celutkiene, J., Escobedo, J., Hoye, A., Lyubarova, R., Mattina, D., Peteiro, J., Smanio, P., Alexander, K. P., Berman, D., Fleg, J., Kwong, R., Senior, R., Min, J., Leipsic, J., Mancini, J., Newman, J., Alexander, K. P., Mathew, R., Sidhu, M., Friedman, L., Anderson, J., Berg, J., DeMets, D., Gibson, C. M., Lamas, G., Deming, N., Himmelfarb, J., Ouyang, P., Woodard, P., Harrell, F., Nwosu, S., Kirby, R., Jeffries, N., Newman, J., Sidhu, M., Denaro, J. E., Mavromichalis, S., Chan, K., Cobb, G., Contreras, A., Cukali, D., Ferket, S., Gabriel, A., Hansen, A., Roberts, A., Naumova, A., Chang, M., Islam, S., Wayser, G., Yakubov, S., Yee, M., Callison, C., Hogan, I., Qelaj, A., Pirro, C., Van Loo, K., Wisniewski, B., Gilsenan, M., Lang, B., Mohamed, S., Esquenazi-Karonika, S., Mathews, P., Setang, V., Xavier, M., Alexander, K. P., Bagai, A., Broderick, S., Crowder, M., Cyr, D., Endsley, P., Garg, J., Gu, X., Hatch, L., Heath, A., Huang, Z., Kanters, J., Lee, K., Leimberger, J., Marcus, J., Page, C., Parker, W., Pennachi, W., Pownall, J., Rockhold, F., Stevens, S., Stone, A., Stournaras, D., Thompson, O., Ussery, S., White, J., Williams, M. K., Xing, W., Zhu, S., Anstrom, K., Baloch, K., Blount, J., Cowper, P., Davidson-Ray, L., Drew, L., Harding, T., Knight, J. D., Minshall Liu, D., O'Neal, B., Redick, T., Jones, P., Nugent, K., Jingyan Wang, G., Phillips, L., Goyal, A., Hetrick, H., Oliver, D., Hayes, S. W., Friedman, J. D., Gerlach, R. J., Hyun, M., Miranda-Peats, R., Slomka, P., Thomson, L., Kwong, R. Y., Friedrich, M., Mongeon, F. P., Michael, S., Hung, J., Scherrer-Crosbie, M., Zeng, X., Eckstein, J., Guruge, B., Streif, M., Alfonso, M. A., Corral, M. P., Garcia, J. J., Jankovic, I., Konigstein, M., Lustre, M. B., Peralta, Y., Sanchez, R., Min, J., Arsanjani, R., Budoff, M., Elmore, K., Gomez, M., Hague, C., Hindoyan, N., Leipsic, J., Mancini, G. J., Nakanishi, R., Srichai-Parsia, M. B., Yeoh, E., Youn, T., Maggioni, A. P., Bianchini, F., Ceseri, M., Lorimer, A., Magnoni, M., Orso, F., Sarti, L., Tricoli, M., Carvalho, A., Lopes, R., Barbosa, L. M., Bello Duarte, T., Colaiacovo Soares, T., de Aveiro Morata, J., Carvalho, P., de Carvalho Maffei, N., Egydio, F., Kawakami, A., Oliveira, J., Restelli Piloto, E., Pozzibon, J., Goodman, S., Camara, D., Mowafy, N., Spindler, C., Jiang, L., Dai, H., Feng, F., Li, J., Li, L., Liu, J., Xie, Q., Zhang, H., Zhang, J., Zhang, L., Zhang, L., Zhang, N., Zhong, H., Diaz, R., Escobar, C., Martin, M. E., Pascual, A., Lopez-Sendon, J., Moraga, P., Hernandez, V., Castro, A., Posada, M., Fernandez, S., Narro Villanueva, J. L., Selgas, R., Steg, G., Abergel, H., Juliard, J. M., White, H., Alsweiler, C., Van de Werf, F., Claes, K., Goetschalckx, K., Luyten, A., Robesyn, V., Selvanayagam, J. B., Murphy, D., Garcevic, N., Stojkovic, J., Ahmed, A., Bhatt, R., Chadha, N., Kumar, V., Lubna, S., Naik, P., Pandey, S., Ramasamy, K., Saleem, M., Sharma, P., Siddaram, H. 2023Abstract
BACKGROUND: Anatomic complete revascularization (ACR) and functional complete revascularization (FCR) have been associated with reduced death and myocardial infarction (MI) in some prior studies. The impact of complete revascularization (CR) in patients undergoing an invasive (INV) compared with a conservative (CON) management strategy has not been reported.OBJECTIVES: Among patients with chronic coronary disease without prior coronary artery bypass grafting randomized to INV vs CON management in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial, we examined the following: 1) the outcomes of ACR and FCR compared with incomplete revascularization; and 2) the potential impact of achieving CR in all INV patients compared with CON management.METHODS: ACR and FCR in the INV group were assessed at an independent core laboratory. Multivariable-adjusted outcomes of CR were examined in INV patients. Inverse probability weighted modeling was then performed to estimate the treatment effect had CR been achieved in all INV patients compared with CON management.RESULTS: ACR and FCR were achieved in 43.4% and 58.4% of 1,824 INV patients. ACR was associated with reduced 4-year rates of cardiovascular death or MI compared with incomplete revascularization. By inverse probability weighted modeling, ACR in all 2,296 INV patients compared with 2,498 CON patients was associated with a lower 4-year rate of cardiovascular death or MI (difference-3.5; 95%CI:-7.2% to 0.0%). In comparison, the event rate difference of cardiovascular death or MI for INV minus CON in the overall ISCHEMIA trial was-2.4%. Results were similar but less pronounced with FCR.CONCLUSIONS: The outcomes of an INV strategy may be improved if CR (especially ACR) is achieved. (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches [ISCHEMIA]; NCT01471522).
View details for DOI 10.1016/j.jacc.2023.06.015
View details for PubMedID 37462593