For Physicians

Whom to Contact

  • If you are a site that was participating in the ISCHEMIA study, are currently participating in ISCHEMIA-EXTEND, or would like to learn more about future studies please contact ISCHEMIA@nyulangone.org for more information.

Rationale of the ISCHEMIA-EXTEND Study

  • The ISCHEMIA and ISCHEMIA-CKD trials showed that an invasive strategy with cardiac catheterization followed by PCI or coronary artery bypass graft surgery (CABG) added to guideline-directed medical therapy with pharmacologic and lifestyle interventions did not reduce the overall rate of death or myocardial infarction (MI) compared with an initial conservative strategy of guideline-directed medical therapy alone in stable patients with moderate or severe ischemia on a stress test. In addition to this finding:
    • Among participants with angina at baseline in ISCHEMIA, invasive management improved symptoms better than conservative management. Patients that were more symptomatic at baseline derived the greatest benefit from an invasive compared to conservative strategy.
    • The ISCHEMIA-CKD Trial found that invasive management did not reduce symptoms appreciably or improve quality of life compared with conservative management.
    • These results do not apply to people with a recent MI or those with severe or unstable chest pain symptoms.
  • Following the evidence provided by the ISCHEMIA and ISCHEMIA-CKD Trial, an extended follow-up (ISCHEMIA-EXTEND) of randomized participants is needed to assess whether a difference emerges in long-term mortality when comparing an initial invasive and conservative strategy.
  • For more information, please see the primary clinical and QOL results for the ISCHEMIA and ISCHEMIA-CKD Trial, published in the New England Journal of Medicine.
    • Initial Invasive or Conservative Strategy for Stable Coronary Disease. (Published April 9 2020) Link
    • Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease. (Published April 9 2020) Link
    • Management of Coronary Disease in Patients with Advanced Kidney Disease. (Published April 23 2020) Link
    • Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease. (Published April 23 2020) Link

ISCHEMIA-EXTEND Study Design

  • Over 5,000 participants worldwide entered ISCHEMIA-EXTEND when this follow-up study began.
  • Participants’ vital status will be collected for over 6 additional years of follow-up beyond the initial follow-up period (median 3.2 years for ISCHEMIA and median 2.2 years for ISCHEMIA-CKD), projected median of 10 years of total follow-up.
  • Follow-Up for participants’ vital status will be performed every 6 months, except for a few sites that will follow up yearly.