Virtual ACC 2020 | ISCHEMIA-CKD: Invasive Strategy vs. Medical Treatment in Higher Risk Patients

This pre-specified protocol originally included 777 patients with chronic kidney failure. These patients are a special population of higher risk where we might be able to see the advantage of a more aggressive initial strategy.

Death or MI rate (combined primary end point) resulted 36.4% for the invasive strategy vs. 36.7% for the initially conservative strategy with optimal medical treatment (HR 1.01; CI 95% 0.79-1.29). 

Secondary end points such as death rate considered separately, non-fatal MI, hospitalization due to unstable angina, cardiac failure or cardiac arrest also resulted practically identical with 38.5% vs 39.7%, respectively (HR 1.01; CI 95% 0.79 to 1.29).

Stroke rate increased with the invasive strategy (HR 3.76; 95% CI 1.52-9.32) as well as risk of dialysis HR (1.48; CI 95% 1.04-2.11).


Read also: Virtual ACC 2020 | Controversial Trial ISCHEMIA Finally in NEJM.


And it this weren’t enough, patients with chronic kidney failure didn’t even show symptom improvement after revascularization. 

Descargar (PDF, Unknown)

Original Title: Management of coronary disease in patients with advanced kidney disease.

Reference: Bangalore S et al. N Engl J Med. 2020; Epub ahead of print y presentado en forma virtual en el ACC 2020.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

*

Top