Outcomes with revascularisation versus conservative management of participants with 3-vessel coronary artery disease in the ISCHEMIA trial
Authors' conclusion
In participants with 3V-CAD, REV (either PCI or CABG) was associated with a lower 4-year CV death/MI rate and improved quality of life, with similar results for PCI versus CON and CABG versus CON.
Study context
- Population
- ISCHEMIA participants with 3-vessel CAD on coronary CT angiography, without prior CABG
- Participants
- 1,236 participants
- Comparison
- Revascularisation vs conservative management with medical therapy
- INVn = 612
- CONn = 624reference
- Primary endpoint
- CV death/MI
- Follow-up
- 4 years
Methodological detailsBayesian analysis, regression-modelled adjusted estimates
- Bayesian analysis
- Regression-modelled adjusted estimates
Primary result
As reported in the abstract
Each group vs CONAdjusted difference, percentage points (95% CrI)
REVCrI; Pr [benefit]=94.8%
−4.4(−8.7 to −0.3)
PCICrI; Pr [benefit]=96.4%
−5.8(−10.8 to −0.5)
CABGCrI; Pr [benefit]=84.7%
−3.7(−8.8 to 1.5)
Further findings
| Outcome | Adjusted difference (percentage points) (95% CrI) | |
|---|---|---|
| Death and CV death · 4 yearsREVvs CONDeath; CrI · CrI | −1.2 (−4.7 to 2.2) | |
| Death and CV death · 4 yearsREVvs CONCV death; CrI · CrI | −2.3 (−5.5 to 0.8) | |
| Seattle Angina Questionnaire-7 summary score · 12 monthsREVvs CONCrI | 4.6 (2.7–6.4) | |
| Seattle Angina Questionnaire-7 summary score · 12 monthsPCIvs CONCrI | 3.6 (1.2–5.8) | |
| Seattle Angina Questionnaire-7 summary score · 12 monthsCABGvs CONCrI | 4.3 (1.5–6.9) | |
| −10−50510Difference, percentage points (linear scale) |
- Death and cardiovascular (CV) death — Pr (benefit) for death with revascularisation (REV) (PCI or CABG) vs CON
- 49-63%
Death and CV death · 4 years
- Similar results for PCI and for CABG
Seattle Angina Questionnaire-7 summary score · 12 months
- Differences favoured REV, with high Pr (benefit)
Original publication
Outcomes with revascularisation versus conservative management of participants with 3-vessel coronary artery disease in the ISCHEMIA trial. EuroIntervention. Published 21 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →