Coronary disease & ACSSecondary analysis
Trajectories of Angina After Initial Invasive vs Conservative Strategy for Chronic Coronary Disease
- Secondary analysis of the ISCHEMIA randomised trial
- ordinal latent trajectory analysis
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
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
| Outcome | Invasive | Conservative |
|---|---|---|
| Modest angina with minimal change | Not reported in the abstract | 42.1% |
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
Summarised from the published abstract; every number is checked against it