Survival rates similar for varying coronary heart disease treatment strategies

A medical image shows the heart and circulatory system

No significant differences were detected in overall death rates among adults with coronary heart disease who had a procedure to improve circulation or who followed standard treatment guidelines. This news came from an interim analysis from the NHLBI-funded International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) Extended Follow-up (ISCHEMIA-EXTEND). The findings published in Circulation and were simultaneously presented at the American Heart Association’s Scientific Sessions 2022.

“These longer-term results build on our original findings, which is that patients with daily or even weekly angina will likely see improved quality of life, but it is not going to prolong life,” said Judith S. Hochman, M.D., the first study author and study chair. “Either strategy is acceptable, which is good news for patients, who have different preferences.”

Through ISCHEMIA, more than 5,000 adults with coronary heart disease were assigned to have an invasive treatment strategy or followed traditional medical guidelines. Invasive treatment approaches were based on a patient’s eligibility and may have included having a stent inserted into a coronary artery to improve blood flow or having a bypass around the blocked artery to reroute circulation. The standard treatment approach focused on primary prevention, such as through diet and exercise, and medication while reserving procedures to improve circulation for necessary cases. The original study, which spanned about 3.2 years, found no major differences in cardiovascular health outcomes based on either treatment approach. However, adults with regular chest pain reported feeling better after having a procedure to improve circulation.

The preliminary ISCHEMIA-EXTEND findings provide insight after about 5-6 years of follow-up, but participants will be followed for up to 10 years.