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
Source:
New England Journal of Medicine
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.