Coronary disease & ACSRandomised controlled trial
Initial Invasive or Conservative Strategy for Stable Coronary Disease
- Randomised controlled trial
Authors' conclusion
Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used.
Study context
- Population
- Stable coronary disease with moderate or severe ischemia
- Participants
- 5,179 participants
- Comparison
- Initial invasive strategy vs initial conservative strategy
- Primary endpoint
- CV death, MI, or hospitalization for unstable angina, HF, or resuscitated cardiac arrest
Primary result
As reported in the abstract
median 3.2 years
Invasive strategy
318
events
Conservative strategy
352
events
Invasive strategy vs Conservative strategyDifference, percentage points (95% CI)
at 6 months
1.9(0.8–3.0)
at 5 years
−1.8(−4.7 to 1.0)
Secondary outcomes
events
| Outcome | Invasive strategy | Conservative strategy | HR (95% CI) | |
|---|---|---|---|---|
| Death | 145 | 144 | 1.05 (0.83–1.32) | |
| 0.512Hazard ratio (log scale) |
CV death or MI (key secondary)
- Results similar to the primary outcome
Primary outcome by MI definition
- Incidence sensitive to MI definition; secondary analysis yielded more procedural MIs of uncertain clinical importance
Original publication
Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. Published 30 March 2020. doi:10.1056/nejmoa1915922
Summarised from the published abstract; every number is checked against it