ISCHEMIA The ISCHEMIA trial showed that heart procedures added to taking medicines and making lifestyle changes did not reduce the overall rate of heart attack or death compared with medicines and lifestyle changes alone. However, for people with chest pain symptoms, heart procedures improved symptoms better than medicines and lifestyle changes alone. The more chest pain to begin with, the more symptoms improved after getting a stent or bypass surgery.
ISCHEMIA-CKD The ISCHEMIA-CKD trial showed that heart procedures added to taking medicines and making lifestyle changes did not result in a reduced rate of heart attack or death compared with medicines and lifestyle changes alone. The trial also showed that heart procedures did not reduce symptoms appreciably or improve the quality of life compared with medicines and lifestyle changes alone. These results do not apply to people having a heart attack or those with severe chest pain symptoms.
What is Ischemia of the Heart?
- When a heart artery narrows, part of the heart may not receive enough blood to work normally. Doctors call this “ischemia.” The most common symptom of ischemia is chest pain (angina), but not everyone with ischemia has symptoms. Ischemia is associated with a higher risk of having a heart attack.
How is Ischemia Treated?
- Doctors use two standard ways to treat ischemia of the heart muscle:
- One way (“medical therapy”) uses medicines and lifestyle changes to control symptoms and risk factors (such as smoking, high blood pressure, and high cholesterol).
- Another way uses an invasive procedure called cardiac catheterization to see your heart arteries, and either stents are put in the narrowed arteries to restore blood flow or surgery is done to bypass the narrowed arteries and increase blood flow to the heart muscle. Medicines and lifestyle changes are also recommended to control risk factors.
What is a Clinical Trial?
- A clinical trial is a research study with volunteers that is designed to discover which treatment improves results for patients. Clinical trials usually compare different treatments like medications, procedures, or devices.
What is the ISCHEMIA Trial?
- The ISCHEMIA trial was a clinical trial that compared two standard treatments for patients with ischemia of the heart to learn which one is better and safer:
- Starting treatment with medicines and lifestyle changes alone, with a plan to use cardiac procedures only if they are needed, OR
- Starting treatment with invasive cardiac procedures (cardiac catheterization), and then stent placement or bypass surgery along with medicines and lifestyle changes
- The initial phase of the ISCHEMIA Trial has been completed and we are now in the EXTENDed Follow-Up (EXTEND) phase. For ISCHEMIA Trial results, please click here.
What is the ISCHEMIA-CKD Trial?
- An international comparative effectiveness trial to determine the best way to manage chronic coronary disease in patients with advanced chronic kidney disease (eGFR <30 or on dialysis).
- Patients with advanced CKD with moderate to severe ischemia on stress testing were randomized to this Trial.
- For ISCHEMIA-CKD Trial results, please click here.
What is ISCHEMIA-EXTEND?
- ISCHEMIA-EXTEND is the long-term follow-up of randomized, surviving participants in the ISCHEMIA and ISCHEMIA-CKD trials.
- ISCHEMIA-EXTEND assesses whether an initial invasive strategy—cardiac catheterization and revascularization when feasible plus optimal medical therapy (OMT)—reduces long-term all-cause mortality as compared with an initial conservative strategy of OMT for chronic coronary disease patients with moderate or severe ischemia.
Privacy Notice:
The ISCHEMIA Coordinating Center and its identified local representatives plan to collect and use your personal and health information once, and only in the specific ways, you have granted us permission to do in the informed consent (e.g., by giving us your formal, written consent).
New York University Langone Health and Northwick Park Hospital at the London North West University Healthcare NHS Trust will serve jointly as the data controllers for purposes of this research. We will collect personal data both directly from you, and also from searches of publicly accessible databases where you have already provided consent (e.g., medical record searches in select hospitals, requests to NHS Digital). All personal data is being collected as part of a research trial that aims to provide a public benefit. Anonymized, safeguarded data will be shared with the National Institutes of Health in the United States, as is a required element of this research. Because all data is completely anonymized, we do not expect your participation to impact your individual privacy in any way.
Research subjects are entitled to withdraw consent at any time. However, in accordance with Human Research Authority, anonymized data already collected may still be used for trial-related purposes.
If you have any questions regarding your personal data, or if/how your data is used, please contact ischemia@nyulangone.org.