Applicability and eligibility of the international study of comparative health effectiveness with medical and invasive approaches (Ischemia) for patients who underwent revascularization with percutaneous coronary intervention

Nozomi Niimi, Mitsuaki Sawano, Nobuhiro Ikemura, Toshiyuki Nagai, Shintaro Nakano, Satoshi Shoji, Yasuyuki Shiraishi, Ikuko Ueda, Yohei Numasawa, Masahiro Suzuki, Shigetaka Noma, Keiichi Fukuda, Shun Kohsaka

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

In the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial, an early invasive strategy did not decrease mortality compared to a conservative strategy for stable ischemic heart disease (SIHD) patients with moderate-to-severe ischemia, and the role of revascularization would be revised. However, the applicability and potential influence of this trial in daily practice remains unclear. Our objective was to assess the eligibility and representativeness of the ISCHEMIA trial on the patients with percutaneous coronary intervention (PCI). From a multicenter registry, we extracted a consecutive 13,223 SIHD patients with PCI (baseline cohort). We applied ISCHEMIA eligibility criteria and compared the baseline characteristics between the eligible patients and the actual study participants (randomized controlled trial (RCT) patients). In 3463 patients with follow-up information (follow-up cohort), the 2 year composite of major adverse cardiac events was evaluated between the eligible patients and RCT patients, as well as eligible and non-eligible patients in the registry. In the baseline cohort, 77.3% of SIHD patients with moderate-to-severe ischemia were eligible for the ISCHEMIA. They were comparable with RCT patients for baseline characteristics and outcomes unlike the non-eligible patients. In conclusion, the trial results seem applicable for the majority of PCI patients with moderate-to-severe ischemia except for the non-eligible patients.

Original languageEnglish
Article number2889
Pages (from-to)1-14
Number of pages14
JournalJournal of Clinical Medicine
Volume9
Issue number9
DOIs
Publication statusPublished - 2020 Sep

Keywords

  • ISCHEMIA
  • Percutaneous coronary intervention
  • Registry
  • Stable ischemic heart disease

ASJC Scopus subject areas

  • Medicine(all)

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