The ISCHEMIA trial (2020) changed practice regarding the management of stable ischaemic heart disease. Its principal finding was:
- A PCI was superior to CABG for multivessel disease in diabetics
- B FFR-guided PCI reduced mortality compared to angiography-guided PCI
- C Routine invasive strategy did not reduce death or MI compared to optimal medical therapy alone in stable CAD ✓
- D High-intensity statins alone eliminated the need for coronary revascularisation
Correct answer: C. Routine invasive strategy did not reduce death or MI compared to optimal medical therapy alone in stable CAD
Explanation
The ISCHEMIA trial enrolled patients with stable coronary artery disease and moderate-to-severe ischaemia and showed no significant difference in major adverse cardiovascular events (death, MI) between a routine invasive strategy (catheterisation + revascularisation) and conservative optimal medical therapy over a median follow-up of ~3.3 years. This reinforced the primacy of aggressive medical management for stable CAD. Invasive therapy still improved angina-related quality of life.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.