NCT01471522

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

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
5,179

participants targeted

Target at P75+ for not_applicable cardiovascular-diseases

Timeline
Completed

Started Jul 2012

Longer than P75 for not_applicable cardiovascular-diseases

Geographic Reach
35 countries

314 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 10, 2011

Completed
5 days until next milestone

First Posted

Study publicly available on registry

November 15, 2011

Completed
8 months until next milestone

Study Start

First participant enrolled

July 1, 2012

Completed
7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2019

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

July 23, 2020

Completed
2.9 years until next milestone

Study Completion

Last participant's last visit for all outcomes

May 30, 2023

Completed
Last Updated

June 1, 2023

Status Verified

May 1, 2023

Enrollment Period

7 years

First QC Date

November 10, 2011

Results QC Date

June 29, 2020

Last Update Submit

May 30, 2023

Conditions

Outcome Measures

Primary Outcomes (12)

  • Primary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, Heart Failure, or Resuscitated Cardiac Arrest

    3.2 year follow-up (median)

  • Cumulative Event Rate of Primary Composite Outcome (Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, Heart Failure, or Resuscitated Cardiac Arrest)

    This measure represents the estimated cumulative probability of experiencing the primary endpoint within the indicated timeframe in each treatment group. The interpretation of the measure is similar to Kaplan-Meier event rates. Estimates are expressed as percentages ranging from 0% (endpoint is certain not to occur) to 100% (endpoint is certain to occur).

    5 years

  • Number of Participants That Experienced Death From Cardiovascular Causes or Myocardial Infarction

    5 years

  • Cumulative Event Rate of Death From Cardiovascular Causes or Myocardial Infarction

    This measure represents the estimated cumulative probability of experiencing Death from cardiovascular causes or myocardial infarction within the indicated timeframe in each treatment group. The interpretation of the measure is similar to Kaplan-Meier event rates. Estimates are expressed as percentages ranging from 0% (endpoint is certain not to occur) to 100% (endpoint is certain to occur).

    5 years

  • Number of Participants That Experienced Death From Any Cause

    5 years

  • Cumulative Event Rate of Death From Any Cause

    5 years

  • Number of Participants That Experienced Myocardial Infarction

    5 years

  • Cumulative Event Rate of Myocardial Infarction

    5 years

  • Estimated Difference in Cumulative Event Rate ( %) of Primary Composite Outcome: Invasive Minus Conservative

    The primary composite outcome includes death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest.

    5 years

  • Estimated Difference in Cumulative Event Rate of Death From Cardiovascular Causes: Invasive Minus Conservative or Myocardial Infarction Between Invasive and Conservative Strategies

    5 years

  • Estimated Difference in Cumulative Event Rate of Death From Any Cause: Invasive Minus Conservative

    5 years

  • Estimated Difference in Cumulative Event Rate of Myocardial Infarction: Invasive Minus Conservative

    5 years

Study Arms (2)

Invasive Strategy (INV)

ACTIVE COMPARATOR

Routine invasive strategy with cardiac catheterization followed by revascularization plus optimal medical therapy.

Procedure: cardiac catheterizationProcedure: coronary artery bypass graft surgeryProcedure: percutaneous coronary interventionBehavioral: LifestyleDrug: Medication

Conservative Strategy

ACTIVE COMPARATOR

Optimal medical therapy with cardiac catheterization and revascularization reserved for patients with acute coronary syndrome, ischemic heart failure, resuscitated cardiac arrest or refractory symptoms.

Behavioral: LifestyleDrug: Medication

Interventions

Narrowed blood vessels can be opened without surgery using stents or can be bypassed with surgery. To determine which is the best approach for you the doctor needs to look at your blood vessels to see where the narrowings are and how much narrowing there is. This is done by a procedure known as a cardiac catheterization.

Also known as: cath
Invasive Strategy (INV)

Artery narrowing is bypassed during surgery with a healthy artery or vein from another part of the body. This is known as coronary artery bypass grafting, or CABG (said, "cabbage"). The surgery creates new routes around narrowed and blocked heart arteries. This allows more blood flow to the heart.

Also known as: CABG
Invasive Strategy (INV)

Percutaneous coronary intervention may be done as part of the cardiac catheterization procedure. With this procedure a small, hollow, mesh tube (stent) is inserted into the narrowed part of the artery. The stent pushes the plaque against the artery wall, and opens the vessel to allow better blood flow.

Also known as: PCI
Invasive Strategy (INV)
LifestyleBEHAVIORAL

diet, physical activity, smoking cessation

Also known as: Behavior change
Conservative StrategyInvasive Strategy (INV)

antiplatelet, statin, other lipid lowering, antihypertensive, and anti-ischemic medical therapies

Also known as: Pharmacologic Therapy
Conservative StrategyInvasive Strategy (INV)

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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

You may not qualify if:

  • 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
  • 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
  • +12 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (320)

UAB Vascular Biology and Hypertension Program

Birmingham, Alabama, 35294, United States

Location

Yuma Regional Medical Center

Yuma, Arizona, 85364, United States

Location

Cedars Sinai Medical Center

Beverly Hills, California, 90211, United States

Location

UCSF - Fresno Community Regional Medical Center

Fresno, California, 93721, United States

Location

Ronald Reagan UCLA Medical Center

Los Angeles, California, 90095, United States

Location

University of California Irvine Medical Center

Orange, California, 92868, United States

Location

Palo Alto Medical Foundation Research Institute

Palo Alto, California, 94087, United States

Location

VA Palo Alto HealthCare System

Palo Alto, California, 94550, United States

Location

Kaiser Permanente San Jose

San Jose, California, 94538, United States

Location

Coastal Heart Medical Group

Santa Ana, California, 92704, United States

Location

Stanford University School of Medicine

Stanford, California, 94305, United States

Location

Torrance Memorial Medical Center

Torrance, California, 90505, United States

Location

South Denver Cardiology Associates, P.C.

Littleton, Colorado, 80120, United States

Location

Medical Center of the Rockies

Loveland, Colorado, 80538, United States

Location

VA Connecticut Healthcare System

West Haven, Connecticut, 06111, United States

Location

Daytona Heart Group

Daytona Beach, Florida, 32114, United States

Location

Malcom Randall VAMC

Gainesville, Florida, 32608, United States

Location

Mayo Clinic Florida

Jacksonville, Florida, 32224, United States

Location

Cardiovascular Center of Sarasota

Sarasota, Florida, 34239, United States

Location

Sarasota Memorial Hospital

Sarasota, Florida, 34239, United States

Location

University of South Florida

Tampa, Florida, 33606, United States

Location

Emory University

Atlanta, Georgia, 30322, United States

Location

Atlanta VA Medical Center

Decatur, Georgia, 30033, United States

Location

Advanced Heart Care Group

Fairview Heights, Illinois, 62208, United States

Location

Loyola University Medical Center

Maywood, Illinois, 60153, United States

Location

Indiana University/Krannert Institute of Cardiology

Indianapolis, Indiana, 46202, United States

Location

Midwest Cardiovascular Research Foundation

Davenport, Iowa, 52803, United States

Location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

Location

University of Kentucky

Lexington, Kentucky, 40536, United States

Location

Lexington VA Medical Center

Lexington, Kentucky, 42503, United States

Location

University of Louisville

Louisville, Kentucky, 40292, United States

Location

Cardiovascular Specialists of Southwest Louisiana

Lake Charles, Louisiana, 70601, United States

Location

University of Maryland Medical Center

Baltimore, Maryland, 21201, United States

Location

NIH Heart Center at Suburban Hospital

Bethesda, Maryland, 20814, United States

Location

Walter Reed National Military Medical Center

Bethesda, Maryland, 20889, United States

Location

Brigham & Women's Hospital, Harvard Medical School

Boston, Massachusetts, 02115, United States

Location

Boston Medical Center

Boston, Massachusetts, 02118, United States

Location

VA Boston Healthcare System

West Roxbury, Massachusetts, 02132, United States

Location

Saint Vincent Hospital at Worcester Medical Center

Worcester, Massachusetts, 01608, United States

Location

Henry Ford Health System

Detroit, Michigan, 48202, United States

Location

Spectrum Health

Grand Rapids, Michigan, 49503, United States

Location

Covenant Medical Center, Inc.

Saginaw, Michigan, 01876, United States

Location

Providence - Providence Park Hospital

Southfield, Michigan, 48075, United States

Location

Michigan Heart, PC

Ypsilanti, Michigan, 48197, United States

Location

Minneapolis VAMC

Minneapolis, Minnesota, 55417, United States

Location

University of Minnesota

Minneapolis, Minnesota, 55455, United States

Location

Mayo Clinic

Rochester, Minnesota, 55905, United States

Location

HealthEast Saint Joseph's Hospital

Saint Paul, Minnesota, 55102, United States

Location

Saint Luke's Hospital

Kansas City, Missouri, 64111, United States

Location

Kansas City VA Medical Center

Kansas City, Missouri, 64128, United States

Location

Englewood Hospital and Medical Center

Englewood, New Jersey, 07631, United States

Location

AtlantiCare Regional Medical Center

Pomona, New Jersey, 08240, United States

Location

Hackensack University Medical Center

Saddle Brook, New Jersey, 07663, United States

Location

Albany Medical Center Hospital

Albany, New York, 12208, United States

Location

Samuel Stratton VA Medical Center of Albany NY

Albany, New York, 12208, United States

Location

Capital Cardiology Associates

Albany, New York, 12211, United States

Location

NYU-HHC Kings County Hospital Center

Brooklyn, New York, 11203, United States

Location

New York -Presbyterian/Brooklyn Methodist Hospital

Brooklyn, New York, 11215, United States

Location

NYU-HHC Woodhull Hospital

Brooklyn, New York, 11229, United States

Location

Coney Island Hospital

Brooklyn, New York, 11235, United States

Location

NYP Medical Medical Group Hudson Valley Cardiology

Cortlandt Manor, New York, 10567, United States

Location

New York University - Langone Cardiovascular Associates

Flushing, New York, 11355, United States

Location

Mid Valley Cardiology

Kingston, New York, 12401, United States

Location

Northwell Health - Manhasset

Manhasset, New York, 11030, United States

Location

NYU Winthrop

Mineola, New York, 11501, United States

Location

VA New York Harbor Health Care System

New York, New York, 10010, United States

Location

Beth Israel Medical Center

New York, New York, 10016, United States

Location

NYU Langone Medical Center-Bellevue Hospital

New York, New York, 10016, United States

Location

NYU New York Medical Associates

New York, New York, 10022, United States

Location

Mount Sinai Saint Luke's Hospital

New York, New York, 10025, United States

Location

Icahn School of Medicine at Mount Sinai

New York, New York, 10029, United States

Location

Columbia University Medical Center

New York, New York, 10032, United States

Location

University of Rochester

Rochester, New York, 14642, United States

Location

Cardiology Associates of Schenectady P.C.

Schenectady, New York, 12309, United States

Location

NYU-HHC Lincoln Medical and Mental Health Center

The Bronx, New York, 10451, United States

Location

Jacobi Medical Center

The Bronx, New York, 10461, United States

Location

Asheville Cardiology Associates

Asheville, North Carolina, 28803, United States

Location

Duke University Medical Center

Durham, North Carolina, 27710, United States

Location

Sanford Health

Fargo, North Dakota, 58122, United States

Location

Cincinnati VA Medical Center

Cincinnati, Ohio, 45220, United States

Location

Louis Stokes Cleveland Veterans Affairs Medical Center

Cleveland, Ohio, 44106, United States

Location

Ohio Health Grant Medical Center

Columbus, Ohio, 43215, United States

Location

Oklahoma Heart Institute

Tulsa, Oklahoma, 74133, United States

Location

Oregon Health & Science University

Portland, Oregon, 97201, United States

Location

Providence Heart and Vascular Institute

Portland, Oregon, 97225, United States

Location

Saint Luke's Hospital and Health Network

Bethlehem, Pennsylvania, 18018, United States

Location

Holy Spirit Hospital Cardiovascular Institute

Camp Hill, Pennsylvania, 17011, United States

Location

Doylestown Health Cardiology

Doylestown, Pennsylvania, 18901, United States

Location

Conemaugh Valley Memorial Hospital

Johnstown, Pennsylvania, 15905, United States

Location

Miriam Hospital

Providence, Rhode Island, 02906, United States

Location

Kent Hospital

Warwick, Rhode Island, 02886, United States

Location

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

Location

Saint Thomas Hospital

Nashville, Tennessee, 373203, United States

Location

V.A. North Texas Health Care System

Dallas, Texas, 75216, United States

Location

Baylor College of Medicine

Houston, Texas, 77030, United States

Location

Baylor St. Luke's Medical Center

Houston, Texas, 77030, United States

Location

Houston Heart & Vascular Associates

Houston, Texas, 77339, United States

Location

Baylor Research Institute at Legacy Heart Center

Plano, Texas, 75024, United States

Location

The Heart Hospital Baylor

Plano, Texas, 75093, United States

Location

Audie Murphy V.A.

San Antonio, Texas, 78229, United States

Location

Medicus Alliance Clinical Research Org., Inc.

Sugar Land, Texas, 77478, United States

Location

Wichita Falls Heart Clinic

Wichita Falls, Texas, 76301, United States

Location

Salt Lake City VA Medical Center

Salt Lake City, Utah, 84148, United States

Location

VAMC-White River Junction

White River Junction, Vermont, 05009, United States

Location

Cardiovascular Associates, Ltd.

Chesapeake, Virginia, 23320, United States

Location

Stroobants Cardiovascular Center

Lynchburg, Virginia, 24501, United States

Location

Winchester Cardiology and Vascular Medicine, PC

Winchester, Virginia, 22601, United States

Location

University of Washington Medical Center

Bellevue, Washington, 98004, United States

Location

Gundersen Lutheran Medical Center

La Crosse, Wisconsin, 54601, United States

Location

Hospital Italiano Regional del Sur Bahia Blanca

Bahía Blanca, Buenos Aires, 8000, Argentina

Location

Fundacion Favaloro

Ciudad Autonoma de Buenos Aires, Buenos Aires, C1093AAS, Argentina

Location

Instituto Medico DAMIC

Córdoba, CBA, 5009, Argentina

Location

Clinica Del Prado

Córdoba, 5000, Argentina

Location

Clinica Romagosa and Clinica De La Familia

Córdoba, 5000, Argentina

Location

Clínica Privada Vélez Sarsfield

Córdoba, 5000, Argentina

Location

John Hunter Hospital

New Lambton Heights, New South Wales, 2305, Australia

Location

Flinders Medical Centre

Adelaide, South Australia, 5042, Australia

Location

The Queen Elizabeth Hospital

Woodville South, South Australia, 5011, Australia

Location

Royal Perth Hospital

Perth, Western Australia, 6000, Australia

Location

LKH Graz West Austria

Graz, Stmk, 8020, Austria

Location

Medical University of Vienna, Department of Cardiology

Vienna, Vienna, 1090, Austria

Location

Wilhelminen Hospital Vienna

Vienna, Vienna, A-1160, Austria

Location

University Hospital Leuven

Leuven, Brabant, 3000, Belgium

Location

Fundacao Bahiana de Cardilogia

Salvador, Estado de Bahia, 41810-010, Brazil

Location

Hospital Lifecenter

Belo Horizonte, Minas Gerais, 30110-921, Brazil

Location

Hospital Maternidade e Pronto Socorro Santa Lucia

Poços de Caldas, Minas Gerais, 37701-045, Brazil

Location

Quanta Diagnostico & Terapia

Curitiba, Paraná, 80045-170, Brazil

Location

Hospital Cardiologico Costantini

Curitiba, Paraná, 80320-320, Brazil

Location

Hospital Pró-Cardíaco

Botafogo, Rio de Janeiro, 22280-020, Brazil

Location

Hospital Sao Vicente de Paulo

Fundo, Rio Grande do Sul, 99010080, Brazil

Location

Hospital de Clinicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, 90035-903, Brazil

Location

Hospital Sao Lucas da Pontificia Universidade Catolica do Rio Grande do Sol

Porto Alegre, Rio Grande do Sul, 90610-000, Brazil

Location

Instituto de Cardiologia de Porto Alegre

Porto Alegre, Rio Grande do Sul, 90620-001, Brazil

Location

Instituto Dante Pazzanese de Cardiologia

Ibirapuera, São Paulo, 04012-909, Brazil

Location

Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

Ribeirão Preto, São Paulo, 14048-900, Brazil

Location

Hospital TotalCor

São Paulo, São Paulo, 1418100, Brazil

Location

Hospital da Bahia

Salvador, BA, 41820-011, Brazil

Location

Unifesp - Hospital Sao Paulo

São Paulo, 04025-011, Brazil

Location

Heart Institute (InCor) University of São Paulo

São Paulo, 05403-000, Brazil

Location

Hospital Celso Pierro

São Paulo, 13059-740, Brazil

Location

University of Calgary

Calgary, Alberta, T2N 2T9, Canada

Location

University of Alberta

Edmonton, Alberta, T6G 2B7, Canada

Location

Vancouver General Hospital

Vancouver, British Columbia, V5Z 1M9, Canada

Location

West Lincoln Memorial Hospital

Grimsby, Ontario, L3M 1P3, Canada

Location

Hamilton General Hospital

Hamilton, Ontario, L8L 2X2, Canada

Location

London Health Sciences Centre

London, Ontario, N6A 5A5, Canada

Location

Dixie Medical Group

Mississauga, Ontario, L4W 0C2, Canada

Location

Dr. James Cha

Oshawa, Ontario, L1J 2K1, Canada

Location

Scarborough Cardiology Research

Scarborough Village, Ontario, M1E 5E9, Canada

Location

Saint Catharines General Hospital

St. Catharines, Ontario, L2S0A9, Canada

Location

St. Michael's Hospital

Toronto, Ontario, M5B 1W8, Canada

Location

Women's College Hospital

Toronto, Ontario, M5G 1N8, Canada

Location

University Health Network

Toronto, Ontario, M5G 2C4, Canada

Location

Northwest GTA Cardiovascular and Heart Rhythm Program

Vaughan, Ontario, L4H0P6, Canada

Location

Montreal Heart Institute

Montreal, Quebec, H1T 1C8, Canada

Location

Centre Intégré Universitaire de Santé et de Services Sociaux du Montréal

Montreal, Quebec, H4J 1C5, Canada

Location

CISSSL - Hopital Pierre-Le Gardeur

Terrebonne, Quebec, J6V 2H2, Canada

Location

Centre Hospitalier de Regional Trois-Rivieres

Trois-Rivières, Quebec, G8Z 3R9, Canada

Location

University of Ottawa Heart Institute

Ottawa, K1Y 4W7, Canada

Location

Beijing Chao-yang Hospital, Capital Medical University

Beijing, Beijing Municipality, 100020, China

Location

Chinese Academy of Medical Sciences, Fuwai Hospital

Beijing, Beijing Municipality, 100037, China

Location

Peking Union Medical College Hospital

Beijing, Beijing Municipality, 100730, China

Location

Beijing Anzhen Hospital

Beijing, Chaoyang, 100029, China

Location

Liangxiang Hospital, Beijing Fangshan District

Beijing, Fangshan, 102401, China

Location

Guangdong General Hospital

Guangzhou, Guangdong, 510100, China

Location

Tangshan Gongren Hospital

Tangshan, Hebei, 063000, China

Location

The Second Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, 450014, China

Location

The First Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, 450052, China

Location

Tongji Medical College

Wuhan, Hubei, 430030, China

Location

Wuhan Asia Heart Hospital

Wuhan, Hubei, China

Location

Wuhan Union Hospital, Tongji Medical College, Huazhong Science and Tech University

Wuhan, Hubei, China

Location

Affiliated Zhongshan Hospital of Dalian University

Dalian, Liaoning, 116001, China

Location

Affiliated Hospital of Jining Medical University

Jining, Shandong, 272000, China

Location

Qingdao Fuwai Hospital

Qingdao, Shandong, 266071, China

Location

Shanxi Cardiovascular Hospital

Taiyuan, Shanxi, 030024, China

Location

Shanxi Provincial People's Hospital

Xian, Shanxi, 710000, China

Location

TEDA International Cardiovascular Hospital

Tianjing, Tianjing, 300457, China

Location

First Affiliated Hospital of Xinjiang Medical University

Ürümqi, Xinjiang, 830054, China

Location

The Second Affiliated Hospital Zhejiang University School of Medicine

Hangzhou, Zhejiang, 310009, China

Location

Cairo University

Cairo, 11562, Egypt

Location

C.H. Louis Pasteur

Châtres, Centre-Val de Loire, 28018, France

Location

Grenoble University Hospital

Grenoble, Isere, 38700, France

Location

Centre Hospitalier Universitaire d'Angers

Angers, Pays de la Loire Region, 49933, France

Location

Ambroise Pare Hospital

Boulogne-Billancourt, Île-de-France Region, 92100, France

Location

Antoine-Beclere Hospital

Clamart, Île-de-France Region, 92141, France

Location

Centre Hospitalier Sud Francilien

Corbeil-Essonnes, Île-de-France Region, 91100, France

Location

Bichat Hospital

Paris, Île-de-France Region, 75018, France

Location

Robert-Bosch-Krankenhaus

Stuttgart, Baden-Wurttemberg, 70376, Germany

Location

Universitatsklinikum Bonn

Bonn, North Rhine-Westphalia, 53105, Germany

Location

Praxisklinik Herz Und Gefaesse

Dresden, Saxony, D-01099, Germany

Location

University Hospital Jena

Jena, Thuringia, 07747, Germany

Location

University of Szeged

Szeged, Szeged Megyei Varos, 6720, Hungary

Location

Eszszk- Szent Istvan Hospital

Budapest, 1097, Hungary

Location

Military Hospital, Budapest

Budapest, 1117, Hungary

Location

Heart and Vascular Center, Semmelweis University

Budapest, 1122, Hungary

Location

George Gottsegen National Institute of Cardiology

Budapest, H-1096, Hungary

Location

Gurunanak CARE Hospital

Hyderabad, Andhra Pradesh, 500020, India

Location

CARE Hospital

Hyderabad, Andhra Pradesh, 500034, India

Location

Sri Jayadeva Institute of Cardiovascular Sciences and Research

Bangalore, Karnataka, 560069, India

Location

Government Medical College

Calicut, Kerala, 673008, India

Location

MOSC Medical College Hospital, Kolenchery

Kolenchery, Kerala, 682311, India

Location

Sree Chitra Tirunal Institute for Medical Sciences and Technology

Trivandrum, Kerala, 695011, India

Location

Ruby Hall Clinic,Grant Medical Foundation

Pune, Maharashtra, 411001, India

Location

KEM Hospital Pune

Pune, Maharashtra, 411011, India

Location

Dr Ram Manohar Lohia Hospital

New Delhi, National Capital Territory of Delhi, 110001, India

Location

Fortis Escort Heart Institute

New Delhi, National Capital Territory of Delhi, 110025, India

Location

Batra Hospital and Medical Research Centre (BHMRC)

New Delhi, National Capital Territory of Delhi, 110062, India

Location

Fortis Healthcare Fl.t Lt. Rajan Dhall Hospital

New Delhi, National Capital Territory of Delhi, 110070, India

Location

Hero DMC Heart Institute, Dayanand Medical College and Hospital

Ludhiana, Punjab, 141001, India

Location

Apollo Research and Innovation

Chennai, Tamil Nadu, 600081, India

Location

Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER)

Pondicherry, Tamil Nadu, 605006, India

Location

CARE Nampally

Hyderabad, Telangana, 500001, India

Location

Apollo Research & Innovations

Hyderabad, Telangana, 600081, India

Location

King George's Medical University, Department of Cardiology

Lucknow, Uttar Pradesh, 226003, India

Location

All India Institute of Medical Sciences

New Delhi, 110029, India

Location

Rambam Medical Center

Haifa, 31096, Israel

Location

Assuta Medical Centers

Tel Aviv, 67891, Israel

Location

AORN Dei Colli "V. Monaldi" UOC Cardiologia Università della Campania "L.Vanvitelli"

Napoli, Campania, 80131, Italy

Location

Ospedale "G.B. Morgagni - L. Pierantoni" Forli (AUSL della Romagna)

Forlì, Emilia-Romagna, 47100, Italy

Location

IRCCS "Casa Sollievo della Sofferenza"

San Giovanni Rotondo, FG, 71013, Italy

Location

Policlinico di Monza, Monza MB

Monza, MB, 20900, Italy

Location

Humanitas Research Hospital, Rozzano (MI)

Rozzano, Milano, 20089, Italy

Location

Azienda Ospedaliera S. Croce e Carle

Cuneo, Piedmont, 12100, Italy

Location

Cardiology and CCU - Ospedali Riuniti Ancona

Ancona, The Marches, 60020, Italy

Location

UO Cardiologia Ospedale SS Cosma e Damiano

Pescia, Tuscany, 54100, Italy

Location

Azienda Servizi Sanitaria n.3 Alto Friuli-Collinare-Medio Friuli

Tolmezzo, Udine, 33028, Italy

Location

University of Padua- Cardiology Clinic

Padua, Veneto, 35100, Italy

Location

Ospedale Regionale Umberto Parini

Aosta, 11100, Italy

Location

Clinica Mediterranea

Naples, 80121, Italy

Location

Ospedale di Circolo e Fondazione Macchi

Varese, 21100, Italy

Location

National Cerebral and Cardiovascular Center

Suita-shi, Osaka, 565-8565, Japan

Location

Saitama Medical University

Hidaka, Saitama, 350-0495, Japan

Location

Keio University Hospital

Shinjuku-Ku, Tokyo, 160-8582, Japan

Location

Vilnius University Hospital Santariskes Clinic

Vilnius, LT-08661, Lithuania

Location

Institut Jantung Negara

Kuala Lumpur, Kuala Lumpur, 50400, Malaysia

Location

Instituto Mexicano del Seguro Social

Benito Juárez, Mexico City, 3100, Mexico

Location

Instituto Nacional de Cardiología "Ignacio Chávez"

Mexico City, Mexico City, 14080, Mexico

Location

Cardio Research Hartcentrum OLVG

Amsterdam, North Holland, 1091 AC, Netherlands

Location

Radboudumc

Nijmegen, 6500 HB, Netherlands

Location

Isala Klinieken

Zwolle, 8025 AB, Netherlands

Location

Waikato Hospital

Hamilton, Waikato Region, 3240, New Zealand

Location

Auckland City Hospital

Auckland, 1142, New Zealand

Location

University Clinic of Cardiology

Skopje, Republic of Macedo, 1000, North Macedonia

Location

Instituto Neuro Cardiovascular De Las Americas

Miraflores, Lima region, 18, Peru

Location

T.Marciniak Hospital

Wroclaw, Dolny Śląsk, 54-090, Poland

Location

Department of Coronary Disease, John Paul II Hospital, Jagiellonian University Medical College

Krakow, Maopolskie, 31-200, Poland

Location

Department of Internal Medicine and Cardiology, Infant Jesus Teaching Hospital, Medical University of Warsaw

Warsaw, Masovian Voivodeship, 02-005, Poland

Location

Coronary and Structural Heart Diseases Department, Institute of Cardiology

Warsaw, Masovian Voivodeship, 04-628, Poland

Location

Department of Interventional Cardiology & Angiology, Institute of Cardiology

Warsaw, Masovian Voivodeship, 04-628, Poland

Location

Medical University of Warsaw

Warsaw, Masovian Voivodeship, PL-02-097, Poland

Location

Institute of Cardiology, Warsaw

Warsaw, Mazovian, 04-628, Poland

Location

University Hospital in Bialystok

Bialystok, Podlaskie Voivodeship, 15-276, Poland

Location

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

Zabrze, Silesian Voivodeship, 41-800, Poland

Location

Szpital Kliniczny Przemienienia Pańskiego

Poznan, 61-848, Poland

Location

Military Hospital / Medical University

Wroclaw, 50-981, Poland

Location

Cardiology Clinic, Medical University in Lodz

Lodz, Łódź Voivodeship, 91-425, Poland

Location

Hospital de Santa Marta

Lisbon, 1150-291, Portugal

Location

Santa Maria University Hospital, Cardiology Department, CHLN

Lisbon, 1649-028, Portugal

Location

Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE

Vila Nova de Gaia, 4434-502, Portugal

Location

Emergency County Hospital Baia Mare

Baia Mare, 021967, Romania

Location

Emergency Institute of Cardiovascular Diseases ''Prof. Dr. C. C. Iliescu''

Bucharest, 022328, Romania

Location

National Medical Research Center for Cardiovascuar Surgery

Moscow, Gorod Moskva, 121552, Russia

Location

E.Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation

Novosibirsk, Novosibirsk Oblast, 630055, Russia

Location

Federal Almazov North-West Medical Research Centre

Saint Petersburg, 197341, Russia

Location

North-Western State Medical University

Saint Petersburg, 199106, Russia

Location

King AbdulAziz Cardiac Center

Riyadh, Central Province, 11426, Saudi Arabia

Location

Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia and Faculty of Medicine, University of Novi Sad

Kamenitz, Vojvodina, 21204, Serbia

Location

Clinical Center of Serbia

Belgrade, 11000, Serbia

Location

Faculty of Medicine, University of Belgrade; Cardiology Clinic, Clinical Center of Serbia

Belgrade, 11000, Serbia

Location

University Clinical Hospital Zvezdara

Belgrade, 11000, Serbia

Location

University Hospital Center Bezanijska Kosa

Belgrade, 11000, Serbia

Location

Clinical Center Kragujevac

Kragujevac, 11000, Serbia

Location

Clinic for Cardiovascular Diseases, Clinical Center Nis

Niš, 18000, Serbia

Location

National University Heart Center Singapore

Singapore, 119228, Singapore

Location

National Heart Centre Singapore

Singapore, 169609, Singapore

Location

Tan Tock Seng Hospital

Singapore, 308433, Singapore

Location

Groote Schuur Hospital / University of Cape Town

Cape Town, Western Cape, 7945, South Africa

Location

Hospital Clinico Universitario de Santiago

Santiago de Compostela, La Coruna, 15706, Spain

Location

Complexo Hospitalario Universitario A Coruña (CHUAC) Sergas, Department of Cardiology. INIBIC A Coruña. CIBER-CV. Universidad de A Coruña, Spain

A Coruña, 15008, Spain

Location

Hospital de la Santa Creu i Sant Pau

Barcelona, 08025, Spain

Location

Hospital De Bellvitge

Barcelona, 08907, Spain

Location

Hospital General Universitario Gregorio Maranon

Madrid, 28007, Spain

Location

Hospital La Paz. IdiPaz

Madrid, 28046, Spain

Location

HUVA, Hospital Clínico Universitario Virgen De La Arrixaca

Murcia, 30120, Spain

Location

Hospital Universitario y Politecnico La Fe

Valencia, 46026, Spain

Location

Hospital Universitario Miguel Servet

Zaragoza, 50009, Spain

Location

Karolinska Institutet at Danderyd Hospital

Stockholm, S-18288, Sweden

Location

Uppsala University

Uppsala, SE-751 85, Sweden

Location

Cardiocentro

Lugano, Canton Ticino, 6900, Switzerland

Location

Mackay Memorial Hospital

Taipei, 10449, Taiwan

Location

Maharaj Nakorn Chiang Mai Hospital

Chiang Mai, Meung, 50200, Thailand

Location

Ramathibodi Hospital

Bangkok, 10400, Thailand

Location

Belfast Trust

Belfast, Antrim, BT12 6BA, United Kingdom

Location

Bedford Hospital NHS Trust

Bedford, Bedfordshire, MK42 9DJ, United Kingdom

Location

Luton and Dunstable University Hospital NHS FT

Luton, Berdfordshire, LU4 0DZ, United Kingdom

Location

Papworth Hospital

Cambridge, Cambridgeshire, CB23 3RE, United Kingdom

Location

Peterborough City Hospital

Peterborough, Cambs, PE3 9GZ, United Kingdom

Location

The James Cook University Hospital, Middlesbrough

Middlesbrough, Cleveland, TS4 3BW, United Kingdom

Location

Royal Bournemouth Hospital

Bournemouth, Dorset, BH7 7DW, United Kingdom

Location

Dorset County Hospital

Dorchester, Dorset, DT1 2JY, United Kingdom

Location

The University of Hull/Castle Hill Hospital

Cottingham, East Yorkshire, HU16 5JQ, United Kingdom

Location

Broomfield Hospital

Chelmsford, Essex, CM1 7ET, United Kingdom

Location

Southend University Hospital

Westcliff-on-Sea, Essex, SS0 0RY, United Kingdom

Location

Hampshire Hospitals NHS Foundation Trust

Basingstoke, Hampshire, RG24 9NA, United Kingdom

Location

Blackpool Teaching Hospitals

Blackpool, Lancashire, FY3 8NR, United Kingdom

Location

The Pennine Acute Hospitals NHS Trust

Oldham, Lancashire, OL1 2JH, United Kingdom

Location

Northwick Park Hospital Harrow/ Royal Brompton Hospital London

Harrow, Middlesex, HA1 3UJ, United Kingdom

Location

South Eastern Health and Social Care

Belfast, Northern Ireland, BT16 1RH, United Kingdom

Location

Cardiovascular Research Unit, Craigavon Area Hospital

Craigavon, Northern Ireland, BT63 5QQ, United Kingdom

Location

Nottingham University Hospitals

Nottingham, Notts, NG5 1PB, United Kingdom

Location

Royal Infirmary of Edinburgh

Edinburgh, Scotland, EH4 2XU, United Kingdom

Location

University of Glasgow

Clydebank, Strathclyde, G81 4DY, United Kingdom

Location

Russells Hall Hospital

Dudley, West Midlands, DY1 2HQ, United Kingdom

Location

Bradford Royal Infirmary

Bradford, West Yorkshire, BD9 6RJ, United Kingdom

Location

Pinderfields Hospital

Wakefield, West Yorkshire, WF1 4DG, United Kingdom

Location

University College London Hospitals NHS Foundation Trust/Barts Health NHS Trust

London, EC1A 7BE, United Kingdom

Location

Royal Free London NHS Foundation Trust

London, NW3 2QG, United Kingdom

Location

King's College NHS Foundation Hospital

London, SE13 6LH, United Kingdom

Location

Imperial College Healthcare NHS Trust

London, W12OHS, United Kingdom

Location

Central Manchester University Hospital

Manchester, M13 9WL, United Kingdom

Location

Related Publications (46)

  • 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.

    PMID: 22137077BACKGROUND
  • 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.

    PMID: 23963599BACKGROUND
  • 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.

    PMID: 29778671BACKGROUND
  • 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.

    PMID: 30810700BACKGROUND
  • Kwong RY, Heydari B, Abbasi S, Mongeon FP, Marcotte F, Friedrich M, Shaw LJ, Xu Y, Anthopolos R, Bekeredjian R, Monti L, Selvanayagam J, Lesiak M, Picard MH, Berman DS, Bangalore S, Spertus JA, Stone GW, Boden WE, Min J, Mancini GBJ, Leipsic J, Budoff M, Hague C, Hochman JS, Maron DJ, Reynolds HR; ISCHEMIA Research Group. Stress Cardiac Magnetic Resonance Ischemia Burden and Cardiovascular Events: Post-Hoc Analysis From the ISCHEMIA Trial. JACC Cardiovasc Imaging. 2025 Dec 5:S1936-878X(25)00597-2. doi: 10.1016/j.jcmg.2025.10.015. Online ahead of print.

  • Ikemura N, Jones PG, Fu Z, Chan PS, Sherrod CF 4th, Arnold SV, Cohen DJ, Mark DB, Maron DJ, Hochman JS, Spertus JA; ISCHEMIA Research Group. Trajectories of Angina After Initial Invasive vs Conservative Strategy for Chronic Coronary Disease. J Am Coll Cardiol. 2025 Sep 16;86(11):782-793. doi: 10.1016/j.jacc.2025.06.044.

  • Huded CP, Spertus JA, Jones PG, O'Brien SM, Mark DB, Bangalore S, Stone GW, Williams DO, White HD, Boden WE, Reynolds HR, Hochman JS, Maron DJ; ISCHEMIA Research Group. Health Status Outcomes With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in ISCHEMIA. Circulation. 2025 Sep 23;152(12):846-858. doi: 10.1161/CIRCULATIONAHA.125.073591. Epub 2025 Sep 5.

  • Shaw LJ, Phillips LM, Leipsic J, Broderick S, Mieres JH, Marwick TH, Friedrich MG, Miller T, Lopes RD, Chow B, Cerci R, Blankstein R, DiCarli M, Maron DJ, Hochman JS, Alexander KP, Stone GW, O'Brien S, Chaitman BR, Kwong RY, Picard MH, Berman DS, Reynolds HR; ISCHEMIA Research Group. Comparative Prognosis by Stress ECG and Stress Imaging: Results From the ISCHEMIA Trial. JACC Cardiovasc Imaging. 2025 Sep;18(9):943-955. doi: 10.1016/j.jcmg.2025.03.016. Epub 2025 Jul 9.

  • White HD, O'Brien SM, Boden WE, Fremes SE, Bangalore S, Reynolds HR, Stone GW, Ali ZA, Parakh N, Lopez-Sendon JL, Wang Y, Chen YQ, Mark DB, Chaitman BR, Spertus JA, Maron DJ, Hochman JS; ISCHEMIA Research Group.. Use of coronary artery bypass graft surgery and percutaneous coronary intervention and associated outcomes in the ISCHEMIA trial. Am Heart J. 2025 Nov;289:78-94. doi: 10.1016/j.ahj.2025.05.009. Epub 2025 May 20.

  • Lerner JB, Pleasure M, Min JK, Picard MH, Peteiro J, Senior R, Celutkiene J, Shapiro MD, Pellikka PA, de Quadros AS, Chow BJW, Tamis-Holland JE, Rodriguez F, Fleg JL, Maron DJ, Hochman JS, Reynolds HR; CIAO-ISCHEMIA Research Group. Quantitative Coronary Artery Plaque Parameters and Severity of Ischemia in Patients With INOCA. Circ Cardiovasc Imaging. 2025 Apr;18(4):e017367. doi: 10.1161/CIRCIMAGING.124.017367. Epub 2025 Mar 31. No abstract available.

  • Bangalore S, Mancini GBJ, Leipsic J, Budoff MJ, Xu Y, Anthopolos R, Brilakis ES, Dwivedi A, Spertus JA, Jones PG, Cho YJ, Mark DB, Hague CJ, Min JK, Reynolds HR, Elghamaz A, Nair RG, Mavromatis K, Gosselin G, Banerjee S, Pejkov H, Lindsay S, Grantham JA, Williams DO, Stone GW, O'Brien SM, Hochman JS, Maron DJ; ISCHEMIA Research Group. Invasive vs Conservative Management of Patients With Chronic Total Occlusion: Results From the ISCHEMIA Trial. J Am Coll Cardiol. 2025 Apr 1;85(12):1335-1349. doi: 10.1016/j.jacc.2025.01.029.

  • Maron DJ, Newman JD, Anthopolos R, Lu Y, Stevens S, Boden WE, Mavromatis K, Linefsky J, Nair RG, Bockeria O, Gosselin G, Perna GP, Demchenko E, Foo D, Shapiro MD, Champagne MA, Ballantyne C, McCullough P, Lopez-Sendon JL, Rockhold F, Harrell F, Rosenberg Y, Stone GW, Bangalore S, Reynolds HR, Spertus JA, Hochman JS; ISCHEMIA Research Group. Guideline-Directed Medical Therapy and Outcomes in the ISCHEMIA Trial. J Am Coll Cardiol. 2025 Apr 1;85(12):1317-1331. doi: 10.1016/j.jacc.2025.01.028.

  • Slater J, Maron DJ, Jones PG, Bangalore S, Reynolds HR, Fu Z, Stone GW, Kirby R, Hochman JS, Spertus JA; ISCHEMIA Research Group. Evaluating the Appropriate Use Criteria for Coronary Revascularization in Stable Ischemic Heart Disease Using Randomized Data From the ISCHEMIA Trial. Circ Cardiovasc Qual Outcomes. 2025 Mar;18(3):e010849. doi: 10.1161/CIRCOUTCOMES.124.010849. Epub 2025 Feb 26.

  • Hausvater A, Anthopolos R, Seltzer A, Spruill TM, Spertus JA, Peteiro J, Lopez-Sendon JL, Celutkiene J, Demchenko EA, Kedev S, Beleslin BD, Sidhu MS, Grodzinsky A, Fleg JL, Maron DJ, Hochman JS, Reynolds HR; CIAO-ISCHEMIA Research Group. Sex Differences in Psychosocial Factors and Angina in Patients With Chronic Coronary Disease. J Am Heart Assoc. 2025 Mar 4;14(5):e037909. doi: 10.1161/JAHA.124.037909. Epub 2025 Feb 25.

  • Reynolds HR, Page CB, Shaw LJ, Berman DS, Chaitman BR, Picard MH, Kwong RY, Min JK, Leipsic J, Mancini GBJ, Budoff MJ, Hague CJ, Senior R, Szwed H, Bhargava B, Celutkiene J, Gadkari M, Bainey KR, Doerr R, Ramos RB, Ong P, Naik SR, Steg PG, Goetschalckx K, Chow BJW, Scherrer-Crosbie M, Phillips L, Mark DB, Spertus JA, Alexander KP, O'Brien SM, Boden WE, Bangalore S, Stone GW, Maron DJ, Hochman JS; ISCHEMIA Research Group. Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial. Circ Cardiovasc Interv. 2024 Dec;17(12):e013743. doi: 10.1161/CIRCINTERVENTIONS.123.013743. Epub 2024 Dec 17.

  • Bangalore S, Rhodes G, Maron DJ, Anthopolos R, O'Brien SM, Jones PG, Mark DB, Reynolds HR, Spertus JA, Stone GW, White HD, Xu Y, Fremes SE, Hochman JS, Ischemia Research Group OBOT. Outcomes with revascularisation versus conservative management of participants with 3-vessel coronary artery disease in the ISCHEMIA trial. EuroIntervention. 2024 Oct 21;20(20):e1276-e1287. doi: 10.4244/EIJ-D-24-00240.

  • Ikemura N, Spertus JA, Nguyen D, Fu Z, Jones PG, Reynolds HR, Bangalore S, Bhargava B, Senior R, Elghamaz A, Goodman SG, Lopes RD, Pracon R, Lopez-Sendon J, Maggioni AP, Kohsaka S, Roth GA, White HD, Mavromatis K, Boden WE, Rodriguez F, Hochman JS, Maron DJ; ISCHEMIA Research Group. International Variation in Health Status Benefits in Patients Undergoing Initial Invasive Versus Conservative Management for Chronic Coronary Disease: Insights From the ISCHEMIA Trial. Circ Cardiovasc Qual Outcomes. 2024 Oct;17(10):e010534. doi: 10.1161/CIRCOUTCOMES.123.010534. Epub 2024 Sep 20.

  • Jorda A, Pecho T, Horvath LC, Nishani E, Bull LE, Bergmann F, Nitsche C, Zeitlinger M, Jilma B, Gelbenegger G. Association of Electrocardiogram Findings With Clinical Outcomes in Patients With Chronic Coronary Syndrome: An Analysis of the ISCHEMIA Trials. Am J Med. 2025 Jan;138(1):61-69.e3. doi: 10.1016/j.amjmed.2024.09.007. Epub 2024 Sep 14.

  • Fleg JL, Huang Z, Reynolds HR, Shaw LJ, Chaitman BR, O'Brien SM, Berstein L, Peteiro J, Smanio PEP, Wander GS, Berger JS, Berman DS, Picard MH, Kwong RY, Min JK, Phillips LM, Bangalore S, Maron DJ, Hochman JS; ISCHEMIA Research Group. Ischemia Severity, Coronary Artery Disease Extent, and Exercise Capacity in ISCHEMIA. Circulation. 2024 Jul 9;150(2):165-167. doi: 10.1161/CIRCULATIONAHA.123.066980. Epub 2024 Jul 8. No abstract available.

  • Jorda A, Hengstenberg C, Lang IM, Kautzky-Willer A, Harreiter J, Zeitlinger M, Jilma B, Gelbenegger G. Association of prediabetes with clinical outcomes in patients with chronic coronary syndrome: a post hoc analysis of the ISCHEMIA and ISCHEMIA-CKD trials. Cardiovasc Diabetol. 2024 May 20;23(1):176. doi: 10.1186/s12933-024-02232-z.

  • Pracon R, Spertus JA, Broderick S, Bangalore S, Rockhold FW, Ruzyllo W, Demchenko E, Nageh T, Grossman GB, Mavromatis K, Manjunath CN, Smanio PEP, Stone GW, Mancini GBJ, Boden WE, Newman JD, Reynolds HR, Hochman JS, Maron DJ; ISCHEMIA Research Group. Factors Associated With Coronary Angiography Performed Within 6 Months of Randomization to the Conservative Strategy in the ISCHEMIA Trial. Circ Cardiovasc Interv. 2024 Jun;17(6):e013435. doi: 10.1161/CIRCINTERVENTIONS.123.013435. Epub 2024 Apr 17.

  • Arnold SV, Jones PG, Maron DJ, Cohen DJ, Mark DB, Reynolds HR, Bangalore S, Chen J, Newman JD, Harrington RA, Stone GW, Hochman JS, Spertus JA; ISCHEMIA Research Group. Variation in Health Status With Invasive vs Conservative Management of Chronic Coronary Disease. J Am Coll Cardiol. 2024 Apr 16;83(15):1353-1366. doi: 10.1016/j.jacc.2024.02.019.

  • Reynolds HR, Cyr DD, Merz CNB, Shaw LJ, Chaitman BR, Boden WE, Alexander KP, Rosenberg YD, Bangalore S, Stone GW, Held C, Spertus J, Goetschalckx K, Bockeria O, Newman JD, Berger JS, Elghamaz A, Lopes RD, Min JK, Berman DS, Picard MH, Kwong RY, Harrington RA, Thomas B, O'Brien SM, Maron DJ, Hochman JS; ISCHEMIA Research Group *. Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial. J Am Heart Assoc. 2024 Mar 5;13(5):e029850. doi: 10.1161/JAHA.122.029850. Epub 2024 Feb 27.

  • Mavromatis K, Jones PG, Ali ZA, Stone GW, Rhodes GM, Bangalore S, O'Brien S, Genereux P, Horst J, Dressler O, Goodman S, Alexander K, Mathew A, Chen J, Bhargava B, Uxa A, Boden WE, Mark DB, Reynolds HR, Maron DJ, Hochman JS, Spertus JA; ISCHEMIA Research Group. Complete Revascularization and Angina-Related Health Status in the ISCHEMIA Trial. J Am Coll Cardiol. 2023 Jul 25;82(4):295-313. doi: 10.1016/j.jacc.2023.05.025.

  • Stone GW, Ali ZA, O'Brien SM, Rhodes G, Genereux P, Bangalore S, Mavromatis K, Horst J, Dressler O, Poh KK, Nath RK, Moorthy N, Witkowski A, Dwivedi SK, Bockeria O, Chen J, Smanio PEP, Picard MH, Chaitman BR, Berman DS, Shaw LJ, Boden WE, White HD, Fremes SE, Rosenberg Y, Reynolds HR, Spertus JA, Hochman JS, Maron DJ; ISCHEMIA Research Group. Impact of Complete Revascularization in the ISCHEMIA Trial. J Am Coll Cardiol. 2023 Sep 19;82(12):1175-1188. doi: 10.1016/j.jacc.2023.06.015. Epub 2023 Jul 17.

  • Nguyen DD, Spertus JA, Alexander KP, Newman JD, Dodson JA, Jones PG, Stevens SR, O'Brien SM, Gamma R, Perna GP, Garg P, Vitola JV, Chow BJW, Vertes A, White HD, Smanio PEP, Senior R, Held C, Li J, Boden WE, Mark DB, Reynolds HR, Bangalore S, Chan PS, Stone GW, Arnold SV, Maron DJ, Hochman JS; ISCHEMIA Research Group. Health Status and Clinical Outcomes in Older Adults With Chronic Coronary Disease: The ISCHEMIA Trial. J Am Coll Cardiol. 2023 May 2;81(17):1697-1709. doi: 10.1016/j.jacc.2023.02.048.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • Maron DJ, Hochman JS, Reynolds HR, Bangalore S, O'Brien SM, Boden WE, Chaitman BR, Senior R, Lopez-Sendon J, Alexander KP, Lopes RD, Shaw LJ, Berger JS, Newman JD, Sidhu MS, Goodman SG, Ruzyllo W, Gosselin G, Maggioni AP, White HD, Bhargava B, Min JK, Mancini GBJ, Berman DS, Picard MH, Kwong RY, Ali ZA, Mark DB, Spertus JA, Krishnan MN, Elghamaz A, Moorthy N, Hueb WA, Demkow M, Mavromatis K, Bockeria O, Peteiro J, Miller TD, Szwed H, Doerr R, Keltai M, Selvanayagam JB, Steg PG, Held C, Kohsaka S, Mavromichalis S, Kirby R, Jeffries NO, Harrell FE Jr, Rockhold FW, Broderick S, Ferguson TB Jr, Williams DO, Harrington RA, Stone GW, Rosenberg Y; ISCHEMIA Research Group. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020 Apr 9;382(15):1395-1407. doi: 10.1056/NEJMoa1915922. Epub 2020 Mar 30.

  • Spertus JA, Jones PG, Maron DJ, O'Brien SM, Reynolds HR, Rosenberg Y, Stone GW, Harrell FE Jr, Boden WE, Weintraub WS, Baloch K, Mavromatis K, Diaz A, Gosselin G, Newman JD, Mavromichalis S, Alexander KP, Cohen DJ, Bangalore S, Hochman JS, Mark DB; ISCHEMIA Research Group. Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease. N Engl J Med. 2020 Apr 9;382(15):1408-1419. doi: 10.1056/NEJMoa1916370. Epub 2020 Mar 30.

  • Reynolds HR, Shaw LJ, Min JK, Spertus JA, Chaitman BR, Berman DS, Picard MH, Kwong RY, Bairey-Merz CN, Cyr DD, Lopes RD, Lopez-Sendon JL, Held C, Szwed H, Senior R, Gosselin G, Nair RG, Elghamaz A, Bockeria O, Chen J, Chernyavskiy AM, Bhargava B, Newman JD, Hinic SB, Jaroch J, Hoye A, Berger J, Boden WE, O'Brien SM, Maron DJ, Hochman JS; ISCHEMIA Research Group. Association of Sex With Severity of Coronary Artery Disease, Ischemia, and Symptom Burden in Patients With Moderate or Severe Ischemia: Secondary Analysis of the ISCHEMIA Randomized Clinical Trial. JAMA Cardiol. 2020 Jul 1;5(7):773-786. doi: 10.1001/jamacardio.2020.0822.

  • Azevedo DFC, Lima EG, Ribeiro MOL, Linhares Filho JPP, Serrano Junior CV. Critical analysis of the classic indications for myocardial revascularization. Rev Assoc Med Bras (1992). 2019 Mar;65(3):319-325. doi: 10.1590/1806-9282.65.3.319. Epub 2019 Apr 11.

  • Shaw LJ, Xie JX, Phillips LM, Goyal A, Reynolds HR, Berman DS, Picard MH, Bhargava B, Devlin G, Chaitman BR. Optimising diagnostic accuracy with the exercise ECG: opportunities for women and men with stable ischaemic heart disease. Heart Asia. 2016 Jun 1;8(2):1-7. doi: 10.1136/heartasia-2016-010736. eCollection 2016.

  • Kataoka A, Scherrer-Crosbie M, Senior R, Gosselin G, Phaneuf D, Guzman G, Perna G, Lara A, Kedev S, Mortara A, El-Hajjar M, Shaw LJ, Reynolds HR, Picard MH. The value of core lab stress echocardiography interpretations: observations from the ISCHEMIA Trial. Cardiovasc Ultrasound. 2015 Dec 18;13:47. doi: 10.1186/s12947-015-0043-2.

  • Stone GW, Hochman JS, Williams DO, Boden WE, Ferguson TB Jr, Harrington RA, Maron DJ. Medical Therapy With Versus Without Revascularization in Stable Patients With Moderate and Severe Ischemia: The Case for Community Equipoise. J Am Coll Cardiol. 2016 Jan 5;67(1):81-99. doi: 10.1016/j.jacc.2015.09.056. Epub 2015 Nov 23.

  • Wasilewski J, Polonski L, Lekston A, Osadnik T, Regula R, Bujak K, Kurek A. Who is eligible for randomized trials? A comparison between the exclusion criteria defined by the ISCHEMIA trial and 3102 real-world patients with stable coronary artery disease undergoing stent implantation in a single cardiology center. Trials. 2015 Sep 15;16:411. doi: 10.1186/s13063-015-0934-4.

Related Links

MeSH Terms

Conditions

Cardiovascular DiseasesCoronary DiseaseCoronary Artery DiseaseHeart DiseasesMyocardial Ischemia

Interventions

Cardiac CatheterizationCoronary Artery BypassPercutaneous Coronary InterventionDosage FormsDrug Therapy

Condition Hierarchy (Ancestors)

Vascular DiseasesArteriosclerosisArterial Occlusive Diseases

Intervention Hierarchy (Ancestors)

Heart Function TestsDiagnostic Techniques, CardiovascularDiagnostic Techniques and ProceduresDiagnosisCatheterizationTherapeuticsInvestigative TechniquesMyocardial RevascularizationCardiac Surgical ProceduresCardiovascular Surgical ProceduresSurgical Procedures, OperativeVascular GraftingVascular Surgical ProceduresThoracic Surgical ProceduresEndovascular ProceduresMinimally Invasive Surgical ProceduresPharmaceutical PreparationsTechnology, Pharmaceutical

Results Point of Contact

Title
Anna Naumova
Organization
NYU Langone Health

Study Officials

  • Judith S Hochman, MD

    New York University

    STUDY CHAIR
  • David J Maron, MD

    Stanford University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 10, 2011

First Posted

November 15, 2011

Study Start

July 1, 2012

Primary Completion

June 30, 2019

Study Completion

May 30, 2023

Last Updated

June 1, 2023

Results First Posted

July 23, 2020

Record last verified: 2023-05

Data Sharing

IPD Sharing
Will share

Data will be submitted to the NHLBI according to their guidelines within 3 years after the final patient follow-up (June 30, 2019) or 2 years after the main paper of the trial has been published, whichever comes first.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
June 2022

Locations