[ISCHEMIA - the Largest Ever R andomized Study in Stable Coronary Artery Disease. Baseline Characteristics of
S A Sayganov1, L L Bershteyn1, A E Andreeva1
1State Budgetary Educational Institution of Higher Professional Education, "I. I. Mechnikov North-West State Medical University" of the RF Ministry of Health Care.
Insights
The ISCHEMIA trial investigates optimal treatment for stable coronary artery disease (CAD). This study analyzes baseline patient characteristics from a Russian site to understand current treatment strategies for CAD.
Area of Science:
- Cardiology
- Clinical Trials
- Medical Guidelines
Background:
- Current indications for coronary revascularization in stable coronary heart disease (CHD) rely on outdated clinical trials.
- The ISCHEMIA trial is a major international randomized study addressing optimal treatment strategies for stable coronary artery disease (CAD).
Purpose of the Study:
- To analyze key baseline characteristics of patients included in the ISCHEMIA study at a single Russian site.
- To provide insights into the patient population undergoing evaluation for stable CAD treatment.
Main Methods:
- Patients with stable CHD and at least moderate risk, confirmed by positive stress tests (exercise stress echocardiography) and obstructive coronary artery disease (coronary computed tomography angiography - CCTA), were included.
- Exclusion criteria included significant left main coronary artery stenosis, unstable ischemic heart disease, severe angina, and specific left ventricular ejection fraction (EF) thresholds.
Main Results:
- Analysis of baseline characteristics of patients enrolled in the ISCHEMIA trial at a Russian site.
- Characterization of the patient cohort based on inclusion and exclusion criteria.
Conclusions:
- Understanding baseline characteristics is crucial for interpreting trial results.
- This analysis contributes to the broader understanding of patient profiles within the ISCHEMIA trial.
Abstract:
Indications for coronary revascularization in patients with stable coronary heart disease (CHD), presented in the current international guidelines are largely based on the clinical trials conducted sometimes more than 30 years ago. ISCHEMIA is the major multicenter international randomized trial intended to answer the question about the optimal treatment strategy in stable coronary artery disease at the present time.
Purpose:
To analyze the most important baseline characteristics of patients enrolled in the ISCHEMIA study in one Russian site.
Methods:
The principal inclusion criteria are a positive stress test (in our center, exercise stress echocardiography) of at least moderate risk and obstructive coronary heart disease confirmed by coronary computed tomography angiography (CCTA). Main exclusion criteria are a significant stenosis of the left main coronary artery by CCTA, clinical progression/destabilization of the ischemic heart disease, angina of IV CCS class, left ventricular ejection fraction (EF) 80% - beta blockers, >80% - ACE inhibitors/ARBs. They are at well controlled resting heart rate (.
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