Clinical trial NCT01471522: International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA)
Official title: International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cardiovascular Diseases
Coronary Disease
Coronary Artery Disease
Heart Diseases
Myocardial Ischemia
Lead sponsor: NYU Langone Health
Sponsor class: OTHER
Collaborators: name: New York University
name: Stanford University
name: National Heart, Lung, and Blood Institute (NHLBI)
name: Albany Stratton VA Medical Center
name: Cedars-Sinai Medical Center
name: Columbia University
name: Duke University
name: East Carolina University
name: Emory University
name: Harvard University
name: Massachusetts General Hospital
name: Montreal Heart Institute
name: University of British Columbia
name: University of Missouri, Kansas City
name: Vanderbilt University
First posted: 2011-11-15
Enrollment: 5179
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of the ISCHEMIA trial is to determine the best management strategy for higher-risk patients with stable ischemic heart disease (SIHD). This is a multicenter randomized controlled trial with 5179 randomized participants with moderate or severe ischemia on stress testing. A blinded coronary computed tomography angiogram (CCTA) was performed in most participants with eGFR ≥60 mL/min/1.73m2 to identify and exclude participants with either significant unprotected left main disease (≥50% stenosis) or those without obstructive CAD (\<50% stenosis in all major coronary arteries). Of 8518 participants enrolled, those that had insufficient ischemia, ineligible anatomy demonstrated on CCTA or another exclusion criterion, did not go on to randomization. Eligible participants were then assigned at random to a routine invasive strategy (INV) with cardiac catheterization followed by revascularization, if feasible, plus optimal medical therapy (OMT) or to a conservative strategy (CON) of OMT, with cardiac catheterization and revascularization reserved for those who fail OMT.

SPECIFIC AIMS

A. Primary Aim The primary aim of the ISCHEMIA trial is to determine whether an initial invasive strategy of cardiac catheterization followed by optimal revascularization, if feasible, in addition to OMT, will reduce the primary composite endpoint of cardiovascular death, nonfatal myocardial infarction, resuscitated cardiac arrest, or hospitalization for unstable angina or heart failure in participants with SIHD and moderate or severe ischemia over an average follow-up of approximately 3.5 years compared with an initial conservative strategy of OMT alone with catheterization reserved for failure of OMT.

B. Secondary Aims Secondary aims are to determine whether an initial invasive strategy compared to a conservative strategy will improve: 1) the composite of CV death or MI; 2) angina symptoms and quality of life, as assessed by the Seattle Angina Questionnaire; 3) all-cause mortality; 4) net clinical benefit assessed by including stroke in the primary and secondary composite endpoints; and 5) individual components of the composite endpoints.

Condition: Coronary Disease Procedure: Coronary CT Angiogram Procedure: Cardiac catheterization Phase: Phase III per NIH

Condition: Cardiovascular Diseases Procedure: Angioplasty, Transluminal, Percutaneous Coronary, other catheter-based interventions Phase: Phase III per NIH

Condition: Heart Diseases Procedure: Coronary Artery Bypass Surgery Phase: Phase III per NIH

Detailed description: BACKGROUND:

Evidence supporting a routine invasive practice paradigm for patients with SIHD is outdated. In strategy trials conducted in the 1970s, coronary artery bypass grafting (CABG) improved survival as compared with no CABG in SIHD patients with high-risk anatomic features. The relevance of these studies today is speculative because contemporary secondary prevention-aspirin, beta-blockers, statins, ACE inhibitors, and lifestyle interventions-were used minimally if at all. Subsequent trials have compared percutaneous coronary intervention (PCI) with medical therapy, as PCI has replaced CABG as the dominant method of revascularization for SIHD. To date, PCI has not been shown to reduce death or myocardial infarction (MI) compared with medical therapy in SIHD patients.

COURAGE and BARI 2D, the two largest trials comparing coronary revascularization vs. medical therapy in SIHD patients, found that among patients selected on the basis of coronary anatomy after cardiac catheterization, an initial management strategy of coronary revascularization (PCI, PCI or CABG, respectively) did not reduce the primary endpoints of death or MI (COURAGE), or death (BARI 2D) compared with OMT alone. These data suggest, but do not prove, that routine cardiac catheterization--which often leads to ad hoc PCI through the diagnostic-therapeutic cascade--may not be required in SIHD patients. However, most patients enrolled in COURAGE and BARI 2D who had ischemia severity documented at baseline had only mild or moderate ischemia, leaving open the question of the appropriate role of cardiac catheterization and revascularization among higher-risk patients with more severe ischemia. Observational data suggest that revascularization of patients with moderate-to-severe ischemia is associated with a lower mortality than medical therapy alone, but such data cannot establish a cause and effect relationship. In clinical practice only about half such patients are referred for cardiac catheterization, indicating equipoise. Furthermore, analysis of outcomes for 468 COURAGE patients with moderate-to-severe ischemia at baseline did not reveal a benefit from PCI. This issue cannot be resolved using available data because all prior SIHD strategy trials enrolled patients after cardiac catheterization, introducing undefined selection biases (e.g., highest risk patients not enrolled) and making translation of study results problematic for clinicians managing patients who have not yet had cardiac catheterization.

A clinical trial in SIHD patients uniformly at higher risk (which could not have been performed before COURAGE and BARI 2D results were available) is needed to inform optimal management for such patients.

DESIGN NARRATIVE, INCLUDING MODIFICATIONS DURING THE TRIAL

Primary Endpoint

A composite of CV death, MI, resuscitated cardiac arrest, or hospitalization for unstable angina or heart failure was proposed as the primary endpoint in the application that was funded by NLHBI, with a secondary endpoint of CV death or MI. Study protocol version 1.0 was finalized on January 18, 2012 after review and approval by the protocol review committee (DSMB) with the primary endpoint specified as the composite of CV death or MI. Regarding the final status of the primary endpoint, the protocol stated:

"To ensure that the primary analysis is well-powered and useful, a prospective plan to allow extending follow-up and/or changing the primary endpoint based on aggregate event rate data will be established prior to the first review of unblinded trial data. At a designated time during the trial, an analysis will be conducted to estimate the overall aggregate primary endpoint event rate and project the final number of observed events. If the estimated unconditional power (i.e. based on aggregate event rate data; not by treatment group) is less than the originally targeted 90%, then one or more of the following options will be considered:

1. Extend follow-up to allow more events to accrue.
2. Change the primary endpoint to one that occurs more frequently. The current primary endpoint would become a secondary endpoint. The proposed new primary endpoint would be the composite of CV death, MI, resuscitated cardiac arrest, or hospitalization for unstable angina or heart failure.
3. Follow the recommendation of an independent advisory panel. An independent advisory panel, separate from the DSMB, will be convened for the purpose of reviewing unconditional power estimates and making a recommendation to the NHLBI Director. Members of this panel will not have access to unblinded data by treatment group or other data that may bias their recommendation." All 5 event types were adjudicated throughout the trial. Study protocol v2.0 (January 2014) allowed ischemia eligibility by non-imaging exercise stress test if more stringent (≥70% stenosis) CCTA criteria were met. The 2016 protocol addendum describes the NHLBI-approved reduction in sample size and extension of recruitment and follow-up due to slower than projected recruitment.

The pre-specified first analysis for monitoring and projecting the final aggregate number of primary endpoint events was conducted in 2015. In 2016, the projected need to increase the power by extending follow-up and elevating the 5-component secondary endpoint to become primary was discussed at Steering Committee and Investigator meetings and communicated by email.

An Independent Advisory Panel convened by NHLBI met in May 2017, and in June 2017 NHLBI approved the Independent Advisory Panel's recommendation to elevate the 5-component secondary endpoint to become primary and retain the 2-component composite as a key secondary endpoint. The panel also recommended extension of follow-up. This was communicated to the Steering Committee and Investigators at August and November 2017 meetings and by email. The last visit date was June 30, 2019.

A statistical plan developed for the Independent Advisory Panel process in 2012 specified that a decision about changing the primary endpoint would be targeted to occur before 75% of the final number of primary endpoint events had accrued. Although the final number of primary endpoint events was unknown during the course of the trial, estimates performed at the time of the Advisory Panel meeting suggested that the ratio of accrued endpoint events to final endpoint events was below 50%. See Maron DJ et al. Am Heart J. 2018 201:124-135. PMC6005768 for additional details about modifications to the trial while it was being conducted.

Analysis of Patients' Health Status as a Key Secondary Endpoint

A key secondary objective of the ISCHEMIA trial is to compare the quality of life outcomes-patients' symptoms, functioning and well-being-between those assigned to an invasive strategy as compared with a conservative strategy. In the protocol, angina frequency and disease-specific quality of life measured by the Seattle Angina Questionnaire (SAQ) Angina Frequency and Quality of Life scales, respectively, are described as the tools that will be used to make this comparative assessment. Recent work has indicated that it is possible to combine the information from the individual domain scores in the SAQ into a new Summary Score that captures the information from the SAQ Angina Frequency, Physical Limitation and Quality of Life scales into a single overall score. The advantages of using a summary score as the primary measure of QOL effects of a therapy are a single primary endpoint comparison rather than two or three (eliminating concerns some may have about multiple comparisons) and a more intuitive holistic (patient-centric) interpretation of the effectiveness results. With these advantages in mind, the ISCHEMIA leadership has agreed that the SAQ Summary Score will be designated as the primary way this outcome for this key secondary endpoint of the ISCHEMIA trial will be analyzed and interpreted, with the individual SAQ scores being used in a secondary, explanatory and descriptive role.

PARTICIPATING COUNTRIES:

North America:

Canada; Mexico; USA

South America:

Argentina; Brazil; Peru

Asia:

China; India; Japan; Malaysia; Singapore; Taiwan; Thailand; Russian Federation

Pacifica:

Australia; New Zealand

Europe:

Austria; Belgium; France; Germany; Hungary; Italy; Lithuania; Macedonia; Netherlands; Poland; Portugal; Romania; Serbia; Spain; Sweden; Switzerland; UK

Middle East:

Egypt; Israel; Saudi Arabia

Africa:

South Africa

Eligibility criteria: Inclusion Criteria:

* At least moderate ischemia on a qualifying stress test
* Participant is willing to comply with all aspects of the protocol, including adherence to the assigned strategy, medical therapy and follow-up visits
* Participant is willing to give written informed consent
* Age ≥ 21 years

Exclusion Criteria:

* LVEF \< 35%
* History of unprotected left main stenosis \>50% on prior coronary computed tomography angiography (CCTA) or prior cardiac catheterization (if available)
* Finding of "no obstructive CAD" (\<50% stenosis in all major epicardial vessels) on prior CCTA or prior catheterization, performed within 12 months
* Coronary anatomy unsuitable for either PCI or CABG
* Unacceptable level of angina despite maximal medical therapy
* Very dissatisfied with medical management of angina
* History of noncompliance with medical therapy
* Acute coronary syndrome within the previous 2 months
* PCI within the previous 12 months
* Stroke within the previous 6 months or spontaneous intracranial hemorrhage at any time
* History of ventricular tachycardia requiring therapy for termination, or symptomatic sustained ventricular tachycardia not due to a transient reversible cause
* NYHA class III-IV heart failure at entry or hospitalization for exacerbation of chronic heart failure within the previous 6 months
* Non-ischemic dilated or hypertrophic cardiomyopathy
* End stage renal disease on dialysis or estimated glomerular filtration rate (eGFR) \<30mL/min (not an exclusion criterion for CKD ancillary trial, see CKD ancillary trial, Section 18)
* Severe valvular disease or valvular disease likely to require surgery or percutaneous valve replacement during the trial
* Allergy to radiographic contrast that cannot be adequately pre-medicated, or any prior anaphylaxis to radiographic contrast
* Planned major surgery necessitating interruption of dual antiplatelet therapy (note that patients may be eligible after planned surgery)
* Life expectancy less than the duration of the trial due to non-cardiovascular comorbidity
* Pregnancy (known to be pregnant; to be confirmed before CCTA and/or randomization, if applicable)
* Patient who, in the judgment of the patient's physician, is likely to have significant unprotected left main stenosis (Those who are able to undergo CCTA will have visual assessment of the left main coronary artery by the CCTA core lab)
* Enrolled in a competing trial that involves a non-approved cardiac drug or device
* Inability to comply with the protocol
* Exceeds the weight or size limit for CCTA or cardiac catheterization at the site
* Canadian Cardiovascular Society Class III angina of recent onset, OR angina of any class with a rapidly progressive or accelerating pattern
* Canadian Cardiovascular Society Class IV angina, including unprovoked rest angina
* High risk of bleeding which would contraindicate the use of dual antiplatelet therapy
* Cardiac transplant recipient
* Prior CABG, unless CABG was performed more than 12 months ago, and coronary anatomy has been demonstrated to be suitable for PCI or repeat CABG to accomplish complete revascularization of ischemic areas (CCC approval required)

Primary outcomes:
measure: Primary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, Heart Failure, or Resuscitated Cardiac Arrest
timeFrame: 3.2 year follow-up (median)
measure: Cumulative Event Rate of Primary Composite Outcome (Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, Heart Failure, or Resuscitated Cardiac Arrest)
timeFrame: 5 years
measure: Number of Participants That Experienced Death From Cardiovascular Causes or Myocardial Infarction
timeFrame: 5 years
measure: Cumulative Event Rate of Death From Cardiovascular Causes or Myocardial Infarction
timeFrame: 5 years
measure: Number of Participants That Experienced Death From Any Cause
timeFrame: 5 years
measure: Cumulative Event Rate of Death From Any Cause
timeFrame: 5 years
measure: Number of Participants That Experienced Myocardial Infarction
timeFrame: 5 years
measure: Cumulative Event Rate of Myocardial Infarction
timeFrame: 5 years
measure: Estimated Difference in Cumulative Event Rate ( %) of Primary Composite Outcome: Invasive Minus Conservative
timeFrame: 5 years
measure: Estimated Difference in Cumulative Event Rate of Death From Cardiovascular Causes: Invasive Minus Conservative or Myocardial Infarction Between Invasive and Conservative Strategies
timeFrame: 5 years
measure: Estimated Difference in Cumulative Event Rate of Death From Any Cause: Invasive Minus Conservative
timeFrame: 5 years
measure: Estimated Difference in Cumulative Event Rate of Myocardial Infarction: Invasive Minus Conservative
timeFrame: 5 years
Secondary outcomes:
Other outcomes:
Locations:
city: Birmingham
country: United States
facility: UAB Vascular Biology and Hypertension Program
state: Alabama
city: Yuma
country: United States
facility: Yuma Regional Medical Center
state: Arizona
city: Beverly Hills
country: United States
facility: Cedars Sinai Medical Center
state: California
city: Fresno
country: United States
facility: UCSF - Fresno Community Regional Medical Center
state: California
city: Los Angeles
country: United States
facility: Ronald Reagan UCLA Medical Center
state: California
city: Orange
country: United States
facility: University of California Irvine Medical Center
state: California
city: Palo Alto
country: United States
facility: Palo Alto Medical Foundation Research Institute
state: California
city: Palo Alto
country: United States
facility: VA Palo Alto HealthCare System
state: California
city: San Jose
country: United States
facility: Kaiser Permanente San Jose
state: California
city: Santa Ana
country: United States
facility: Coastal Heart Medical Group
state: California
city: Stanford
country: United States
facility: Stanford University School of Medicine
state: California
city: Torrance
country: United States
facility: Torrance Memorial Medical Center
state: California
city: Littleton
country: United States
facility: South Denver Cardiology Associates, P.C.
state: Colorado
city: Loveland
country: United States
facility: Medical Center of the Rockies
state: Colorado
city: West Haven
country: United States
facility: VA Connecticut Healthcare System
state: Connecticut
city: Daytona Beach
country: United States
facility: Daytona Heart Group
state: Florida
city: Gainesville
country: United States
facility: Malcom Randall VAMC
state: Florida
city: Jacksonville
country: United States
facility: Mayo Clinic Florida
state: Florida
city: Sarasota
country: United States
facility: Cardiovascular Center of Sarasota
state: Florida
city: Sarasota
country: United States
facility: Sarasota Memorial Hospital
state: Florida
city: Tampa
country: United States
facility: University of South Florida
state: Florida
city: Atlanta
country: United States
facility: Emory University
state: Georgia
city: Decatur
country: United States
facility: Atlanta VA Medical Center
state: Georgia
city: Fairview Heights
country: United States
facility: Advanced Heart Care Group
state: Illinois
city: Maywood
country: United States
facility: Loyola University Medical Center
state: Illinois
city: Indianapolis
country: United States
facility: Indiana University/Krannert Institute of Cardiology
state: Indiana
city: Davenport
country: United States
facility: Midwest Cardiovascular Research Foundation
state: Iowa
city: Iowa City
country: United States
facility: University of Iowa Hospitals and Clinics
state: Iowa
city: Lexington
country: United States
facility: University of Kentucky
state: Kentucky
city: Lexington
country: United States
facility: Lexington VA Medical Center
state: Kentucky
city: Louisville
country: United States
facility: University of Louisville
state: Kentucky
city: Lake Charles
country: United States
facility: Cardiovascular Specialists of Southwest Louisiana
state: Louisiana
city: Baltimore
country: United States
facility: University of Maryland Medical Center
state: Maryland
city: Bethesda
country: United States
facility: NIH Heart Center at Suburban Hospital
state: Maryland
city: Bethesda
country: United States
facility: Walter Reed National Military Medical Center
state: Maryland
city: Boston
country: United States
facility: Brigham & Women's Hospital, Harvard Medical School
state: Massachusetts
city: Boston
country: United States
facility: Boston Medical Center
state: Massachusetts
city: West Roxbury
country: United States
facility: VA Boston Healthcare System
state: Massachusetts
city: Worcester
country: United States
facility: Saint Vincent Hospital at Worcester Medical Center
state: Massachusetts
city: Detroit
country: United States
facility: Henry Ford Health System
state: Michigan
city: Grand Rapids
country: United States
facility: Spectrum Health
state: Michigan
city: Saginaw
country: United States
facility: Covenant Medical Center, Inc.
state: Michigan
city: Southfield
country: United States
facility: Providence - Providence Park Hospital
state: Michigan
city: Ypsilanti
country: United States
facility: Michigan Heart, PC
state: Michigan
city: Minneapolis
country: United States
facility: Minneapolis VAMC
state: Minnesota
city: Minneapolis
country: United States
facility: University of Minnesota
state: Minnesota
city: Rochester
country: United States
facility: Mayo Clinic
state: Minnesota
city: Saint Paul
country: United States
facility: HealthEast Saint Joseph's Hospital
state: Minnesota
city: Kansas City
country: United States
facility: Saint Luke's Hospital
state: Missouri
city: Kansas City
country: United States
facility: Kansas City VA Medical Center
state: Missouri
city: Englewood
country: United States
facility: Englewood Hospital and Medical Center
state: New Jersey
city: Pomona
country: United States
facility: AtlantiCare Regional Medical Center
state: New Jersey
city: Saddle Brook
country: United States
facility: Hackensack University Medical Center
state: New Jersey
city: Albany
country: United States
facility: Albany Medical Center Hospital
state: New York
city: Albany
country: United States
facility: Samuel Stratton VA Medical Center of Albany NY
state: New York
city: Albany
country: United States
facility: Capital Cardiology Associates
state: New York
city: Bronx
country: United States
facility: NYU-HHC Lincoln Medical and Mental Health Center
state: New York
city: Bronx
country: United States
facility: Jacobi Medical Center
state: New York
city: Brooklyn
country: United States
facility: NYU-HHC Kings County Hospital Center
state: New York
city: Brooklyn
country: United States
facility: New York -Presbyterian/Brooklyn Methodist Hospital
state: New York
city: Brooklyn
country: United States
facility: NYU-HHC Woodhull Hospital
state: New York
city: Brooklyn
country: United States
facility: Coney Island Hospital
state: New York
city: Cortlandt Manor
country: United States
facility: NYP Medical Medical Group Hudson Valley Cardiology
state: New York
city: Flushing
country: United States
facility: New York University - Langone Cardiovascular Associates
state: New York
city: Kingston
country: United States
facility: Mid Valley Cardiology
state: New York
city: Manhasset
country: United States
facility: Northwell Health - Manhasset
state: New York
city: Mineola
country: United States
facility: NYU Winthrop
state: New York
city: New York
country: United States
facility: VA New York Harbor Health Care System
state: New York
city: New York
country: United States
facility: Beth Israel Medical Center
state: New York
city: New York
country: United States
facility: NYU Langone Medical Center-Bellevue Hospital
state: New York
city: New York
country: United States
facility: NYU New York Medical Associates
state: New York
city: New York
country: United States
facility: Mount Sinai Saint Luke's Hospital
state: New York
city: New York
country: United States
facility: Icahn School of Medicine at Mount Sinai
state: New York
city: New York
country: United States
facility: Columbia University Medical Center
state: New York
city: Rochester
country: United States
facility: University of Rochester
state: New York
city: Schenectady
country: United States
facility: Cardiology Associates of Schenectady P.C.
state: New York
city: Asheville
country: United States
facility: Asheville Cardiology Associates
state: North Carolina
city: Durham
country: United States
facility: Duke University Medical Center
state: North Carolina
city: Fargo
country: United States
facility: Sanford Health
state: North Dakota
city: Cincinnati
country: United States
facility: Cincinnati VA Medical Center
state: Ohio
city: Cleveland
country: United States
facility: Louis Stokes Cleveland Veterans Affairs Medical Center
state: Ohio
city: Columbus
country: United States
facility: Ohio Health Grant Medical Center
state: Ohio
city: Tulsa
country: United States
facility: Oklahoma Heart Institute
state: Oklahoma
city: Portland
country: United States
facility: Oregon Health & Science University
state: Oregon
city: Portland
country: United States
facility: Providence Heart and Vascular Institute
state: Oregon
city: Bethlehem
country: United States
facility: Saint Luke's Hospital and Health Network
state: Pennsylvania
city: Camp Hill
country: United States
facility: Holy Spirit Hospital Cardiovascular Institute
state: Pennsylvania
city: Doylestown
country: United States
facility: Doylestown Health Cardiology
state: Pennsylvania
city: Johnstown
country: United States
facility: Conemaugh Valley Memorial Hospital
state: Pennsylvania
city: Providence
country: United States
facility: Miriam Hospital
state: Rhode Island
city: Warwick
country: United States
facility: Kent Hospital
state: Rhode Island
city: Nashville
country: United States
facility: Vanderbilt University Medical Center
state: Tennessee
city: Nashville
country: United States
facility: Saint Thomas Hospital
state: Tennessee
city: Dallas
country: United States
facility: V.A. North Texas Health Care System
state: Texas
city: Houston
country: United States
facility: Baylor College of Medicine
state: Texas
city: Houston
country: United States
facility: Baylor St. Luke's Medical Center
state: Texas
city: Houston
country: United States
facility: Houston Heart & Vascular Associates
state: Texas
city: Plano
country: United States
facility: Baylor Research Institute at Legacy Heart Center
state: Texas
city: Plano
country: United States
facility: The Heart Hospital Baylor
state: Texas
city: San Antonio
country: United States
facility: Audie Murphy V.A.
state: Texas
city: Sugar Land
country: United States
facility: Medicus Alliance Clinical Research Org., Inc.
state: Texas
city: Wichita Falls
country: United States
facility: Wichita Falls Heart Clinic
state: Texas
city: Salt Lake City
country: United States
facility: Salt Lake City VA Medical Center
state: Utah
city: White River Junction
country: United States
facility: VAMC-White River Junction
state: Vermont
city: Chesapeake
country: United States
facility: Cardiovascular Associates, Ltd.
state: Virginia
city: Lynchburg
country: United States
facility: Stroobants Cardiovascular Center
state: Virginia
city: Winchester
country: United States
facility: Winchester Cardiology and Vascular Medicine, PC
state: Virginia
city: Bellevue
country: United States
facility: University of Washington Medical Center
state: Washington
city: La Crosse
country: United States
facility: Gundersen Lutheran Medical Center
state: Wisconsin
city: Bahia Blanca
country: Argentina
facility: Hospital Italiano Regional del Sur Bahia Blanca
state: Buenos Aires
city: Ciudad Autonoma de Buenos Aires
country: Argentina
facility: Fundacion Favaloro
state: Buenos Aires
city: Cordoba
country: Argentina
facility: Instituto Medico DAMIC
state: CBA
city: Cordoba
country: Argentina
facility: Clinica Del Prado
city: Cordoba
country: Argentina
facility: Clinica Romagosa and Clinica De La Familia
city: Cordoba
country: Argentina
facility: Clínica Privada Vélez Sarsfield
city: New Lambton Heights
country: Australia
facility: John Hunter Hospital
state: New South Wales
city: Adelaide
country: Australia
facility: Flinders Medical Centre
state: South Australia
city: Woodville South
country: Australia
facility: The Queen Elizabeth Hospital
state: South Australia
city: Perth
country: Australia
facility: Royal Perth Hospital
state: Western Australia
city: Graz
country: Austria
facility: LKH Graz West Austria
state: Stmk
city: Vienna
country: Austria
facility: Medical University of Vienna, Department of Cardiology
state: Wien
city: Vienna
country: Austria
facility: Wilhelminen Hospital Vienna
state: Wien
city: Leuven
country: Belgium
facility: University Hospital Leuven
state: Brabant
city: Salvador
country: Brazil
facility: Fundacao Bahiana de Cardilogia
state: Bahia
city: Belo Horizonte
country: Brazil
facility: Hospital Lifecenter
state: Minas Gerais
city: Pocos de Caldas
country: Brazil
facility: Hospital Maternidade e Pronto Socorro Santa Lucia
state: Minas Gerais
city: Curitiba
country: Brazil
facility: Quanta Diagnostico & Terapia
state: Parana
city: Curitiba
country: Brazil
facility: Hospital Cardiologico Costantini
state: Parana
city: Botafogo
country: Brazil
facility: Hospital Pró-Cardíaco
state: Rio De Janeiro
city: Porto Alegre
country: Brazil
facility: Hospital Sao Lucas da Pontificia Universidade Catolica do Rio Grande do Sol
state: Rio Grande Do Sul
city: Porto Alegre
country: Brazil
facility: Instituto de Cardiologia de Porto Alegre
state: Rio Grande Do Sul
city: Fundo
country: Brazil
facility: Hospital Sao Vicente de Paulo
state: RS
city: Porto Alegre
country: Brazil
facility: Hospital de Clinicas de Porto Alegre
state: RS
city: Ibirapuera
country: Brazil
facility: Instituto Dante Pazzanese de Cardiologia
state: Sao Paulo
city: Ribeirao Preto
country: Brazil
facility: Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
state: Sao Paulo
city: Sao Paulo
country: Brazil
facility: Hospital TotalCor
state: SP
city: Salvador
country: Brazil
facility: Hospital da Bahia
city: Sao Paulo
country: Brazil
facility: Unifesp - Hospital Sao Paulo
city: Sao Paulo
country: Brazil
facility: Heart Institute (InCor) University of São Paulo
city: Sao Paulo
country: Brazil
facility: Hospital Celso Pierro
city: Calgary
country: Canada
facility: University of Calgary
state: Alberta
city: Edmonton
country: Canada
facility: University of Alberta
state: Alberta
city: Vancouver
country: Canada
facility: Vancouver General Hospital
state: British Columbia
city: Grimsby
country: Canada
facility: West Lincoln Memorial Hospital
state: Ontario
city: Hamilton
country: Canada
facility: Hamilton General Hospital
state: Ontario
city: London
country: Canada
facility: London Health Sciences Centre
state: Ontario
city: Mississauga
country: Canada
facility: Dixie Medical Group
state: Ontario
city: Oshawa
country: Canada
facility: Dr. James Cha
state: Ontario
city: Scarborough
country: Canada
facility: Scarborough Cardiology Research
state: Ontario
city: St. Catharines
country: Canada
facility: Saint Catharines General Hospital
state: Ontario
city: Toronto
country: Canada
facility: St. Michael's Hospital
state: Ontario
city: Toronto
country: Canada
facility: Women's College Hospital
state: Ontario
city: Toronto
country: Canada
facility: University Health Network
state: Ontario
city: Vaughan
country: Canada
facility: Northwest GTA Cardiovascular and Heart Rhythm Program
state: Ontario
city: Montreal
country: Canada
facility: Montreal Heart Institute
state: Quebec
city: Montréal
country: Canada
facility: Centre Intégré Universitaire de Santé et de Services Sociaux du Montréal
state: Quebec
city: Terrebonne
country: Canada
facility: CISSSL - Hopital Pierre-Le Gardeur
state: Quebec
city: Trois-Rivieres
country: Canada
facility: Centre Hospitalier de Regional Trois-Rivieres
state: Quebec
city: Ottawa
country: Canada
facility: University of Ottawa Heart Institute
city: Beijing
country: China
facility: Beijing Chao-yang Hospital, Capital Medical University
state: Beijing
city: Beijing
country: China
facility: Chinese Academy of Medical Sciences, Fuwai Hospital
state: Beijing
city: Beijing
country: China
facility: Peking Union Medical College Hospital
state: Beijing
city: Beijing
country: China
facility: Beijing Anzhen Hospital
state: Chaoyang
city: Beijing
country: China
facility: Liangxiang Hospital, Beijing Fangshan District
state: Fangshan
city: Guangzhou
country: China
facility: Guangdong General Hospital
state: Guangdong
city: Tangshan
country: China
facility: Tangshan Gongren Hospital
state: Hebei
city: Zhengzhou
country: China
facility: The Second Affiliated Hospital of Zhengzhou University
state: Henan
city: Zhengzhou
country: China
facility: The First Affiliated Hospital of Zhengzhou University
state: Henan
city: Wuhan
country: China
facility: Tongji Medical College
state: Hubei
city: Wuhan
country: China
facility: Wuhan Asia Heart Hospital
state: Hubei
city: Wuhan
country: China
facility: Wuhan Union Hospital, Tongji Medical College, Huazhong Science and Tech University
state: Hubei
city: Dalian
country: China
facility: Affiliated Zhongshan Hospital of Dalian University
state: Liaoning
city: Jining
country: China
facility: Affiliated Hospital of Jining Medical University
state: Shandong
city: Qingdao
country: China
facility: Qingdao Fuwai Hospital
state: Shandong
city: Taiyuan
country: China
facility: Shanxi Cardiovascular Hospital
state: Shanxi
city: Xian
country: China
facility: Shanxi Provincial People's Hospital
state: Shanxi
city: Tianjing
country: China
facility: TEDA International Cardiovascular Hospital
state: Tianjing
city: Urumqi
country: China
facility: First Affiliated Hospital of Xinjiang Medical University
state: Xinjiang
city: Hangzhou
country: China
facility: The Second Affiliated Hospital Zhejiang University School of Medicine
state: Zhejiang
city: Cairo
country: Egypt
facility: Cairo University
city: Chatres
country: France
facility: C.H. Louis Pasteur
state: Centre
city: Boulogne
country: France
facility: Ambroise Pare Hospital
state: Ile De France
city: Corbeil-Essonnes cedex
country: France
facility: Centre Hospitalier Sud Francilien
state: Ile De France
city: Clamart Cedex
country: France
facility: Antoine-Beclere Hospital
state: Ile-de-France
city: Paris
country: France
facility: Bichat Hospital
state: Ile-de-France
city: Grenoble
country: France
facility: Grenoble University Hospital
state: Isere
city: Angers Cedex 9
country: France
facility: Centre Hospitalier Universitaire d'Angers
state: Pays De La Loire
city: Stuttgart
country: Germany
facility: Robert-Bosch-Krankenhaus
state: BW
city: Bonn
country: Germany
facility: Universitatsklinikum Bonn
state: NRW
city: Dresden
country: Germany
facility: Praxisklinik Herz Und Gefaesse
state: Saxony
city: Jena
country: Germany
facility: University Hospital Jena
state: Thuringia
city: Szeged
country: Hungary
facility: University of Szeged
state: Szeged Megyei Varos
city: Budapest
country: Hungary
facility: Eszszk- Szent Istvan Hospital
city: Budapest
country: Hungary
facility: Military Hospital, Budapest
city: Budapest
country: Hungary
facility: Heart and Vascular Center, Semmelweis University
city: Budapest
country: Hungary
facility: George Gottsegen National Institute of Cardiology
city: Hyderabad
country: India
facility: CARE Hospital
state: Andhra Pradesh
city: Hyderabad
country: India
facility: Gurunanak CARE Hospital
state: AP
city: New Delhi
country: India
facility: Dr Ram Manohar Lohia Hospital
state: Delhi
city: New Delhi
country: India
facility: Fortis Escort Heart Institute
state: Delhi
city: New Delhi
country: India
facility: Batra Hospital and Medical Research Centre (BHMRC)
state: Delhi
city: New Delhi
country: India
facility: Fortis Healthcare Fl.t Lt. Rajan Dhall Hospital
state: Delhi
city: Bangalore
country: India
facility: Sri Jayadeva Institute of Cardiovascular Sciences and Research
state: Karnataka
city: Calicut
country: India
facility: Government Medical College
state: Kerala
city: Kolenchery
country: India
facility: MOSC Medical College Hospital, Kolenchery
state: Kerala
city: Trivandrum
country: India
facility: Sree Chitra Tirunal Institute for Medical Sciences and Technology
state: Kerala
city: Pune
country: India
facility: Ruby Hall Clinic,Grant Medical Foundation
state: Maharashtra
city: Pune
country: India
facility: KEM Hospital Pune
state: Maharashtra
city: Ludhiana
country: India
facility: Hero DMC Heart Institute, Dayanand Medical College and Hospital
state: Punjab
city: Chennai
country: India
facility: Apollo Research and Innovation
state: Tamil Nadu
city: Pondicherry
country: India
facility: Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER)
state: Tamil Nadu
city: Hyderabad
country: India
facility: CARE Nampally
state: Telangana
city: Hyderabad
country: India
facility: Apollo Research & Innovations
state: Telangana
city: Lucknow
country: India
facility: King George's Medical University, Department of Cardiology
state: Uttar Pradesh
city: New Delhi
country: India
facility: All India Institute of Medical Sciences
city: Haifa
country: Israel
facility: Rambam Medical Center
city: Tel-Aviv
country: Israel
facility: Assuta Medical Centers
city: Napoli
country: Italy
facility: AORN Dei Colli "V. Monaldi" UOC Cardiologia Università della Campania "L.Vanvitelli"
state: Campania
city: Forli
country: Italy
facility: Ospedale "G.B. Morgagni - L. Pierantoni" Forli (AUSL della Romagna)
state: Emilia-Romagna
city: San Giovanni Rotondo
country: Italy
facility: IRCCS "Casa Sollievo della Sofferenza"
state: FG
city: Ancona
country: Italy
facility: Cardiology and CCU - Ospedali Riuniti Ancona
state: Marche
city: Monza
country: Italy
facility: Policlinico di Monza, Monza MB
state: MB
city: Rozzano
country: Italy
facility: Humanitas Research Hospital, Rozzano (MI)
state: Milano
city: Cuneo
country: Italy
facility: Azienda Ospedaliera S. Croce e Carle
state: Piemonte
city: Pescia
country: Italy
facility: UO Cardiologia Ospedale SS Cosma e Damiano
state: Tuscany
city: Tolmezzo
country: Italy
facility: Azienda Servizi Sanitaria n.3 Alto Friuli-Collinare-Medio Friuli
state: Udine
city: Padua
country: Italy
facility: University of Padua- Cardiology Clinic
state: Veneto
city: Aosta
country: Italy
facility: Ospedale Regionale Umberto Parini
city: Naples
country: Italy
facility: Clinica Mediterranea
city: Varese
country: Italy
facility: Ospedale di Circolo e Fondazione Macchi
city: Suita-shi
country: Japan
facility: National Cerebral and Cardiovascular Center
state: Osaka
city: Hidaka
country: Japan
facility: Saitama Medical University
state: Saitama
city: Shinjuku-Ku
country: Japan
facility: Keio University Hospital
state: Tokyo
city: Vilnius
country: Lithuania
facility: Vilnius University Hospital Santariskes Clinic
city: Kuala Lumpur
country: Malaysia
facility: Institut Jantung Negara
state: Wilayah Persekutuan
city: Benito Juarez
country: Mexico
facility: Instituto Mexicano del Seguro Social
state: DF
city: Mexico City
country: Mexico
facility: Instituto Nacional de Cardiología "Ignacio Chávez"
state: Distrito Federal
city: Amsterdam
country: Netherlands
facility: Cardio Research Hartcentrum OLVG
state: NH
city: Nijmegen
country: Netherlands
facility: Radboudumc
city: Zwolle
country: Netherlands
facility: Isala Klinieken
city: Hamilton
country: New Zealand
facility: Waikato Hospital
state: Waikato
city: Auckland
country: New Zealand
facility: Auckland City Hospital
city: Skopje
country: North Macedonia
facility: University Clinic of Cardiology
state: Republic Of Macedo
city: Miraflores
country: Peru
facility: Instituto Neuro Cardiovascular De Las Americas
state: Lima
city: Wrocław
country: Poland
facility: T.Marciniak Hospital
state: Dolny Śląsk
city: Lodz
country: Poland
facility: Cardiology Clinic, Medical University in Lodz
state: Lodzkie
city: Krakow
country: Poland
facility: Department of Coronary Disease, John Paul II Hospital, Jagiellonian University Medical College
state: Maopolskie
city: Warsaw
country: Poland
facility: Institute of Cardiology, Warsaw
state: Mazovian
city: Warsaw
country: Poland
facility: Coronary and Structural Heart Diseases Department, Institute of Cardiology
state: Mazowieckie
city: Warsaw
country: Poland
facility: Department of Interventional Cardiology & Angiology, Institute of Cardiology
state: Mazowieckie
city: Warsaw
country: Poland
facility: Medical University of Warsaw
state: Mazowieckie
city: Warszawa
country: Poland
facility: Department of Internal Medicine and Cardiology, Infant Jesus Teaching Hospital, Medical University of Warsaw
state: Mazowieckie
city: Bialystok
country: Poland
facility: University Hospital in Bialystok
state: Podlaskie
city: Zabrze
country: Poland
facility: Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases
state: Wojewodztwo Slaskie
city: Poznan
country: Poland
facility: Szpital Kliniczny Przemienienia Pańskiego
city: Wroclaw
country: Poland
facility: Military Hospital / Medical University
city: Lisboa
country: Portugal
facility: Hospital de Santa Marta
city: Lisbon
country: Portugal
facility: Santa Maria University Hospital, Cardiology Department, CHLN
city: Vila Nova de Gaia
country: Portugal
facility: Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE
city: Baia Mare
country: Romania
facility: Emergency County Hospital Baia Mare
city: Bucharest
country: Romania
facility: Emergency Institute of Cardiovascular Diseases ''Prof. Dr. C. C. Iliescu''
city: Moscow
country: Russian Federation
facility: National Medical Research Center for Cardiovascuar Surgery
state: Gorod Moskva
city: Novosibirsk
country: Russian Federation
facility: E.Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation
state: Novosibirskaya Oblast
city: Saint Petersburg
country: Russian Federation
facility: North-Western State Medical University
city: Saint-Petersburg
country: Russian Federation
facility: Federal Almazov North-West Medical Research Centre
city: Riyadh
country: Saudi Arabia
facility: King AbdulAziz Cardiac Center
state: Central Province
city: Sremska Kamenica
country: Serbia
facility: Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia and Faculty of Medicine, University of Novi Sad
state: Vojvodina
city: Belgrade
country: Serbia
facility: Clinical Center of Serbia
city: Belgrade
country: Serbia
facility: Faculty of Medicine, University of Belgrade; Cardiology Clinic, Clinical Center of Serbia
city: Belgrade
country: Serbia
facility: University Clinical Hospital Zvezdara
city: Belgrade
country: Serbia
facility: University Hospital Center Bezanijska Kosa
city: Kragujevac
country: Serbia
facility: Clinical Center Kragujevac
city: Nis
country: Serbia
facility: Clinic for Cardiovascular Diseases, Clinical Center Nis
city: Singapore
country: Singapore
facility: National University Heart Center Singapore
city: Singapore
country: Singapore
facility: National Heart Centre Singapore
city: Singapore
country: Singapore
facility: Tan Tock Seng Hospital
city: Cape Town
country: South Africa
facility: Groote Schuur Hospital / University of Cape Town
state: Western Cape
city: Santiago de Compostela
country: Spain
facility: Hospital Clinico Universitario de Santiago
state: La Coruna
city: A Coruna
country: Spain
facility: Complexo Hospitalario Universitario A Coruña (CHUAC) Sergas, Department of Cardiology. INIBIC A Coruña. CIBER-CV. Universidad de A Coruña, Spain
city: Barcelona
country: Spain
facility: Hospital de la Santa Creu i Sant Pau
city: Barcelona
country: Spain
facility: Hospital De Bellvitge
city: Madrid
country: Spain
facility: Hospital General Universitario Gregorio Maranon
city: Madrid
country: Spain
facility: Hospital La Paz. IdiPaz
city: Murcia
country: Spain
facility: HUVA, Hospital Clínico Universitario Virgen De La Arrixaca
city: Valencia
country: Spain
facility: Hospital Universitario y Politecnico La Fe
city: Zaragoza
country: Spain
facility: Hospital Universitario Miguel Servet
city: Stockholm
country: Sweden
facility: Karolinska Institutet at Danderyd Hospital
city: Uppsala
country: Sweden
facility: Uppsala University
city: Lugano
country: Switzerland
facility: Cardiocentro
state: Ticino
city: Taipei City
country: Taiwan
facility: Mackay Memorial Hospital
city: Chiang Mai
country: Thailand
facility: Maharaj Nakorn Chiang Mai Hospital
state: Meung
city: Bangkok
country: Thailand
facility: Ramathibodi Hospital
city: Belfast
country: United Kingdom
facility: Belfast Trust
state: Antrim
city: Bedford
country: United Kingdom
facility: Bedford Hospital NHS Trust
state: Bedfordshire
city: Luton
country: United Kingdom
facility: Luton and Dunstable University Hospital NHS FT
state: Berdfordshire
city: Cambridge
country: United Kingdom
facility: Papworth Hospital
state: Cambridgeshire
city: Peterborough
country: United Kingdom
facility: Peterborough City Hospital
state: Cambs
city: Middlesbrough
country: United Kingdom
facility: The James Cook University Hospital, Middlesbrough
state: Cleveland
city: Bournemouth
country: United Kingdom
facility: Royal Bournemouth Hospital
state: Dorset
city: Dorchester
country: United Kingdom
facility: Dorset County Hospital
state: Dorset
city: Cottingham
country: United Kingdom
facility: The University of Hull/Castle Hill Hospital
state: East Yorkshire
city: Chelmsford
country: United Kingdom
facility: Broomfield Hospital
state: Essex
city: Westcliff-on-Sea
country: United Kingdom
facility: Southend University Hospital
state: Essex
city: Basingstoke
country: United Kingdom
facility: Hampshire Hospitals NHS Foundation Trust
state: Hampshire
city: Blackpool
country: United Kingdom
facility: Blackpool Teaching Hospitals
state: Lancashire
city: Oldham
country: United Kingdom
facility: The Pennine Acute Hospitals NHS Trust
state: Lancashire
city: Harrow
country: United Kingdom
facility: Northwick Park Hospital Harrow/ Royal Brompton Hospital London
state: Middlesex
city: Belfast
country: United Kingdom
facility: South Eastern Health and Social Care
state: Northern Ireland
city: Craigavon
country: United Kingdom
facility: Cardiovascular Research Unit, Craigavon Area Hospital
state: Northern Ireland
city: Nottingham
country: United Kingdom
facility: Nottingham University Hospitals
state: Notts
city: Edinburgh
country: United Kingdom
facility: Royal Infirmary of Edinburgh
state: Scotland
city: Clydebank
country: United Kingdom
facility: University of Glasgow
state: Strathclyde
city: Dudley
country: United Kingdom
facility: Russells Hall Hospital
state: West Midlands
city: Bradford
country: United Kingdom
facility: Bradford Royal Infirmary
state: West Yorkshire
city: Wakefield
country: United Kingdom
facility: Pinderfields Hospital
state: West Yorkshire
city: London
country: United Kingdom
facility: University College London Hospitals NHS Foundation Trust/Barts Health NHS Trust
city: London
country: United Kingdom
facility: Royal Free London NHS Foundation Trust
city: London
country: United Kingdom
facility: King's College NHS Foundation Hospital
city: London
country: United Kingdom
facility: Imperial College Healthcare NHS Trust
city: Manchester
country: United Kingdom
facility: Central Manchester University Hospital
Study officials:
affiliation: New York University
name: Judith S Hochman, MD
role: STUDY_CHAIR
affiliation: Stanford University
name: David J Maron, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Maron DJ, Stone GW, Berman DS, Mancini GB, Scott TA, Byrne DW, Harrell FE Jr, Shaw LJ, Hachamovitch R, Boden WE, Weintraub WS, Spertus JA. Is cardiac catheterization necessary before initial management of patients with stable ischemic heart disease? Results from a Web-based survey of cardiologists. Am Heart J. 2011 Dec;162(6):1034-1043.e13. doi: 10.1016/j.ahj.2011.09.001.
citation: Phillips LM, Hachamovitch R, Berman DS, Iskandrian AE, Min JK, Picard MH, Kwong RY, Friedrich MG, Scherrer-Crosbie M, Hayes SW, Sharir T, Gosselin G, Mazzanti M, Senior R, Beanlands R, Smanio P, Goyal A, Al-Mallah M, Reynolds H, Stone GW, Maron DJ, Shaw LJ. Lessons learned from MPI and physiologic testing in randomized trials of stable ischemic heart disease: COURAGE, BARI 2D, FAME, and ISCHEMIA. J Nucl Cardiol. 2013 Dec;20(6):969-75. doi: 10.1007/s12350-013-9773-4.
citation: ISCHEMIA Trial Research Group; Maron DJ, Hochman JS, O'Brien SM, Reynolds HR, Boden WE, Stone GW, Bangalore S, Spertus JA, Mark DB, Alexander KP, Shaw L, Berger JS, Ferguson TB Jr, Williams DO, Harrington RA, Rosenberg Y. International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design. Am Heart J. 2018 Jul;201:124-135. doi: 10.1016/j.ahj.2018.04.011. Epub 2018 Apr 21.
citation: Hochman JS, Reynolds HR, Bangalore S, O'Brien SM, Alexander KP, Senior R, Boden WE, Stone GW, Goodman SG, Lopes RD, Lopez-Sendon J, White HD, Maggioni AP, Shaw LJ, Min JK, Picard MH, Berman DS, Chaitman BR, Mark DB, Spertus JA, Cyr DD, Bhargava B, Ruzyllo W, Wander GS, Chernyavskiy AM, Rosenberg YD, Maron DJ; ISCHEMIA Research Group. Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial. JAMA Cardiol. 2019 Mar 1;4(3):273-286. doi: 10.1001/jamacardio.2019.0014.
citation: Reynolds HR, Diaz A, Cyr DD, Shaw LJ, Mancini GBJ, Leipsic J, Budoff MJ, Min JK, Hague CJ, Berman DS, Chaitman BR, Picard MH, Hayes SW, Scherrer-Crosbie M, Kwong RY, Lopes RD, Senior R, Dwivedi SK, Miller TD, Chow BJW, de Silva R, Stone GW, Boden WE, Bangalore S, O'Brien SM, Hochman JS, Maron DJ; ISCHEMIA Research Group. Ischemia With Nonobstructive Coronary Arteries: Insights From the ISCHEMIA Trial. JACC Cardiovasc Imaging. 2023 Jan;16(1):63-74. doi: 10.1016/j.jcmg.2022.06.015. Epub 2022 Sep 14.
citation: Garcia RA, Spertus JA, Benton MC, Jones PG, Mark DB, Newman JD, Bangalore S, Boden WE, Stone GW, Reynolds HR, Hochman JS, Maron DJ; ISCHEMIA Research Group. Association of Medication Adherence With Health Outcomes in the ISCHEMIA Trial. J Am Coll Cardiol. 2022 Aug 23;80(8):755-765. doi: 10.1016/j.jacc.2022.05.045.
citation: Bangalore S, Spertus JA, Stevens SR, Jones PG, Mancini GBJ, Leipsic J, Reynolds HR, Budoff MJ, Hague CJ, Min JK, Boden WE, O'Brien SM, Harrington RA, Berger JS, Senior R, Peteiro J, Pandit N, Bershtein L, de Belder MA, Szwed H, Doerr R, Monti L, Alfakih K, Hochman JS, Maron DJ; ISCHEMIA Research Group. Outcomes With Intermediate Left Main Disease: Analysis From the ISCHEMIA Trial. Circ Cardiovasc Interv. 2022 Apr;15(4):e010925. doi: 10.1161/CIRCINTERVENTIONS.121.010925. Epub 2022 Apr 12.
citation: Mark DB, Spertus JA, Bigelow R, Anderson S, Daniels MR, Anstrom KJ, Baloch KN, Cohen DJ, Held C, Goodman SG, Bangalore S, Cyr D, Reynolds HR, Alexander KP, Rosenberg Y, Stone GW, Maron DJ, Hochman JS; ISCHEMIA Research Group. Comprehensive Quality-of-Life Outcomes With Invasive Versus Conservative Management of Chronic Coronary Disease in ISCHEMIA. Circulation. 2022 Apr 26;145(17):1294-1307. doi: 10.1161/CIRCULATIONAHA.121.057363. Epub 2022 Mar 9.
citation: Senior R, Reynolds HR, Min JK, Berman DS, Picard MH, Chaitman BR, Shaw LJ, Page CB, Govindan SC, Lopez-Sendon J, Peteiro J, Wander GS, Drozdz J, Marin-Neto J, Selvanayagam JB, Newman JD, Thuaire C, Christopher J, Jang JJ, Kwong RY, Bangalore S, Stone GW, O'Brien SM, Boden WE, Maron DJ, Hochman JS; ISCHEMIA Research Group. Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial. J Am Coll Cardiol. 2022 Feb 22;79(7):651-661. doi: 10.1016/j.jacc.2021.11.052.
citation: Newman JD, Anthopolos R, Mancini GBJ, Bangalore S, Reynolds HR, Kunichoff DF, Senior R, Peteiro J, Bhargava B, Garg P, Escobedo J, Doerr R, Mazurek T, Gonzalez-Juanatey J, Gajos G, Briguori C, Cheng H, Vertes A, Mahajan S, Guzman LA, Keltai M, Maggioni AP, Stone GW, Berger JS, Rosenberg YD, Boden WE, Chaitman BR, Fleg JL, Hochman JS, Maron DJ. Outcomes of Participants With Diabetes in the ISCHEMIA Trials. Circulation. 2021 Oct 26;144(17):1380-1395. doi: 10.1161/CIRCULATIONAHA.121.054439. Epub 2021 Sep 15.
citation: Lopez-Sendon JL, Cyr DD, Mark DB, Bangalore S, Huang Z, White HD, Alexander KP, Li J, Nair RG, Demkow M, Peteiro J, Wander GS, Demchenko EA, Gamma R, Gadkari M, Poh KK, Nageh T, Stone PH, Keltai M, Sidhu M, Newman JD, Boden WE, Reynolds HR, Chaitman BR, Hochman JS, Maron DJ, O'Brien SM. Effects of initial invasive vs. initial conservative treatment strategies on recurrent and total cardiovascular events in the ISCHEMIA trial. Eur Heart J. 2022 Jan 13;43(2):148-149. doi: 10.1093/eurheartj/ehab509.
citation: Reynolds HR, Shaw LJ, Min JK, Page CB, Berman DS, Chaitman BR, Picard MH, Kwong RY, O'Brien SM, Huang Z, Mark DB, Nath RK, Dwivedi SK, Smanio PEP, Stone PH, Held C, Keltai M, Bangalore S, Newman JD, Spertus JA, Stone GW, Maron DJ, Hochman JS. Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity. Circulation. 2021 Sep 28;144(13):1024-1038. doi: 10.1161/CIRCULATIONAHA.120.049755. Epub 2021 Sep 9.
citation: White HD, O'Brien SM, Alexander KP, Boden WE, Bangalore S, Li J, Manjunath CN, Lopez-Sendon JL, Peteiro J, Gosselin G, Berger JS, Maggioni AP, Reynolds HR, Hochman JS, Maron DJ. Comparison of Days Alive Out of Hospital With Initial Invasive vs Conservative Management: A Prespecified Analysis of the ISCHEMIA Trial. JAMA Cardiol. 2021 Sep 1;6(9):1023-1031. doi: 10.1001/jamacardio.2021.1651.
citation: Chaitman BR, Alexander KP, Cyr DD, Berger JS, Reynolds HR, Bangalore S, Boden WE, Lopes RD, Demkow M, Piero Perna G, Riezebos RK, McFalls EO, Banerjee S, Bagai A, Gosselin G, O'Brien SM, Rockhold FW, Waters DD, Thygesen KA, Stone GW, White HD, Maron DJ, Hochman JS; ISCHEMIA Research Group. Myocardial Infarction in the ISCHEMIA Trial: Impact of Different Definitions on Incidence, Prognosis, and Treatment Comparisons. Circulation. 2021 Feb 23;143(8):790-804. doi: 10.1161/CIRCULATIONAHA.120.047987. Epub 2020 Dec 3.
citation: Lopes RD, Alexander KP, Stevens SR, Reynolds HR, Stone GW, Pina IL, Rockhold FW, Elghamaz A, Lopez-Sendon JL, Farsky PS, Chernyavskiy AM, Diaz A, Phaneuf D, De Belder MA, Ma YT, Guzman LA, Khouri M, Sionis A, Hausenloy DJ, Doerr R, Selvanayagam JB, Maggioni AP, Hochman JS, Maron DJ. Initial Invasive Versus Conservative Management of Stable Ischemic Heart Disease in Patients With a History of Heart Failure or Left Ventricular Dysfunction: Insights From the ISCHEMIA Trial. Circulation. 2020 Nov 3;142(18):1725-1735. doi: 10.1161/CIRCULATIONAHA.120.050304. Epub 2020 Aug 29.
citation: Gala ABE, Curzen N. Is There Still a Place for Revascularisation in the Management of Stable Coronary Artery Disease Following the ISCHEMIA Trial? Heart Int. 2020 Aug 8;14(1):13-15. doi: 10.17925/HI.2020.14.1.13. eCollection 2020.
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