Coronary disease & ACS

Trajectories of Angina After Initial Invasive vs Conservative Strategy for Chronic Coronary Disease

J Am Coll CardiolPublished Secondary analysis of the ISCHEMIA randomised trial

Authors' conclusion

A greater proportion of conservatively managed patients experienced unfavorable angina patterns over 2 years compared with those treated invasively.

Study context

Population
Participants with chronic coronary disease, moderate to severe ischemia and baseline angina (enrolled July 2012 to January 2018)with baseline angina
Participants
2,977 participants
Comparison
Initial invasive vs initial conservative strategy
  • Invasiven = 1,505
  • Conservativen = 1,472reference
Primary endpoint
Angina frequency trajectories (SAQ-AF: daily/weekly 0-60, monthly 61-99, no angina 100 points)
Follow-up
2 years
Methodological detailsordinal latent trajectory analysis
  • Ordinal latent trajectory analysis

Primary result

As reported in the abstract

Angina trajectory patterns (six patterns identified in each arm, qualitatively similar)

Rapid resolution

Early improvement with persistent infrequent angina

OutcomeInvasiveConservative
Modest angina with minimal change— not stated in the abstract42.1%

— not stated in the abstract

Original publication

Trajectories of Angina After Initial Invasive vs Conservative Strategy for Chronic Coronary Disease. J Am Coll Cardiol. Published 16 September 2025. doi:10.1016/j.jacc.2025.06.044

Composed by AI from the published abstract and checked against it. How Briefs are made →

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