The ISCHEMIA trial (2019) enrolled patients with stable coronary artery disease and moderate-to-severe ischemia on stress testing. Its major finding was:

• A Routine revascularization significantly reduced overall mortality compared to optimal medical therapy
• B Medical therapy was inferior for angina control at 1 year
• C PCI improved survival but CABG did not
• D Routine early invasive strategy did not reduce primary outcome of CV death or MI over optimal medical therapy ✓

Explanation

The ISCHEMIA trial (2019) found that in stable CAD with moderate-to-severe ischemia, a routine invasive strategy (PCI or CABG) did not reduce the primary endpoint of CV death, MI, hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest compared to optimal medical therapy over a median 3.3 years. Invasive therapy did improve angina quality-of-life outcomes. This landmark trial reinforced that medical optimization is the foundation for stable CAD management.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.