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Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention

In the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial, an early invasive strategy did not decrease mortality compared to a conservative strategy for stable ischemic heart disease (SIHD) patients with moderate-to-severe ischemia, and the...

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Autores principales: Niimi, Nozomi, Sawano, Mitsuaki, Ikemura, Nobuhiro, Nagai, Toshiyuki, Nakano, Shintaro, Shoji, Satoshi, Shiraishi, Yasuyuki, Ueda, Ikuko, Numasawa, Yohei, Suzuki, Masahiro, Noma, Shigetaka, Fukuda, Keiichi, Kohsaka, Shun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564619/
https://www.ncbi.nlm.nih.gov/pubmed/32906673
http://dx.doi.org/10.3390/jcm9092889
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author Niimi, Nozomi
Sawano, Mitsuaki
Ikemura, Nobuhiro
Nagai, Toshiyuki
Nakano, Shintaro
Shoji, Satoshi
Shiraishi, Yasuyuki
Ueda, Ikuko
Numasawa, Yohei
Suzuki, Masahiro
Noma, Shigetaka
Fukuda, Keiichi
Kohsaka, Shun
author_facet Niimi, Nozomi
Sawano, Mitsuaki
Ikemura, Nobuhiro
Nagai, Toshiyuki
Nakano, Shintaro
Shoji, Satoshi
Shiraishi, Yasuyuki
Ueda, Ikuko
Numasawa, Yohei
Suzuki, Masahiro
Noma, Shigetaka
Fukuda, Keiichi
Kohsaka, Shun
author_sort Niimi, Nozomi
collection PubMed
description In the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial, an early invasive strategy did not decrease mortality compared to a conservative strategy for stable ischemic heart disease (SIHD) patients with moderate-to-severe ischemia, and the role of revascularization would be revised. However, the applicability and potential influence of this trial in daily practice remains unclear. Our objective was to assess the eligibility and representativeness of the ISCHEMIA trial on the patients with percutaneous coronary intervention (PCI). From a multicenter registry, we extracted a consecutive 13,223 SIHD patients with PCI (baseline cohort). We applied ISCHEMIA eligibility criteria and compared the baseline characteristics between the eligible patients and the actual study participants (randomized controlled trial (RCT) patients). In 3463 patients with follow-up information (follow-up cohort), the 2 year composite of major adverse cardiac events was evaluated between the eligible patients and RCT patients, as well as eligible and non-eligible patients in the registry. In the baseline cohort, 77.3% of SIHD patients with moderate-to-severe ischemia were eligible for the ISCHEMIA. They were comparable with RCT patients for baseline characteristics and outcomes unlike the non-eligible patients. In conclusion, the trial results seem applicable for the majority of PCI patients with moderate-to-severe ischemia except for the non-eligible patients.
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spelling pubmed-75646192020-10-29 Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention Niimi, Nozomi Sawano, Mitsuaki Ikemura, Nobuhiro Nagai, Toshiyuki Nakano, Shintaro Shoji, Satoshi Shiraishi, Yasuyuki Ueda, Ikuko Numasawa, Yohei Suzuki, Masahiro Noma, Shigetaka Fukuda, Keiichi Kohsaka, Shun J Clin Med Article In the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial, an early invasive strategy did not decrease mortality compared to a conservative strategy for stable ischemic heart disease (SIHD) patients with moderate-to-severe ischemia, and the role of revascularization would be revised. However, the applicability and potential influence of this trial in daily practice remains unclear. Our objective was to assess the eligibility and representativeness of the ISCHEMIA trial on the patients with percutaneous coronary intervention (PCI). From a multicenter registry, we extracted a consecutive 13,223 SIHD patients with PCI (baseline cohort). We applied ISCHEMIA eligibility criteria and compared the baseline characteristics between the eligible patients and the actual study participants (randomized controlled trial (RCT) patients). In 3463 patients with follow-up information (follow-up cohort), the 2 year composite of major adverse cardiac events was evaluated between the eligible patients and RCT patients, as well as eligible and non-eligible patients in the registry. In the baseline cohort, 77.3% of SIHD patients with moderate-to-severe ischemia were eligible for the ISCHEMIA. They were comparable with RCT patients for baseline characteristics and outcomes unlike the non-eligible patients. In conclusion, the trial results seem applicable for the majority of PCI patients with moderate-to-severe ischemia except for the non-eligible patients. MDPI 2020-09-07 /pmc/articles/PMC7564619/ /pubmed/32906673 http://dx.doi.org/10.3390/jcm9092889 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Niimi, Nozomi
Sawano, Mitsuaki
Ikemura, Nobuhiro
Nagai, Toshiyuki
Nakano, Shintaro
Shoji, Satoshi
Shiraishi, Yasuyuki
Ueda, Ikuko
Numasawa, Yohei
Suzuki, Masahiro
Noma, Shigetaka
Fukuda, Keiichi
Kohsaka, Shun
Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention
title Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention
title_full Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention
title_fullStr Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention
title_full_unstemmed Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention
title_short Applicability and Eligibility of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) for Patients who Underwent Revascularization with Percutaneous Coronary Intervention
title_sort applicability and eligibility of the international study of comparative health effectiveness with medical and invasive approaches (ischemia) for patients who underwent revascularization with percutaneous coronary intervention
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564619/
https://www.ncbi.nlm.nih.gov/pubmed/32906673
http://dx.doi.org/10.3390/jcm9092889
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