Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease

RCT (n=777) reports no difference in secondary outcome after 6 months (health status with the Seattle Angina Questionnaire SAQ) between those undergoing revascularisation via an invasive strategy vs those managed medically

SPS commentary:

In the ISCHEMIA-CKD trial (published separately), the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischaemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml/minute/1.73 m2 or receipt of dialysis).


In a related editorial, authors note that important advances have occurred in both strategies, leading to equipoise as to which approach is preferable for patients with stable ischaemic heart disease.


New England Journal of Medicine

Resource links:

Link to ISCHEMIA-CKD trial

Link to editorial