Takeaway
- Myocardial ischemia on stress testing shows no association with a composite of cardiovascular (CV) events or with ventricular function among patients with stable multivessel coronary artery disease (CAD).
Why this matters
- Some findings had suggested an association between myocardial ischemia on stress testing and later events in these patients, which has been used to guide revascularization decisions.
- More recent data suggested no role at least for moderate ischemia in treatment outcomes.
Key results
- Compared with no baseline ischemia, ischemia at baseline was not linked to event-free survival:
- aHR, 1.00 (95% CI, 0.80-1.27).
- Ventricular functional decline was similar with or without baseline ischemia (P=.97).
- Outcomes did not change with therapy type (percutaneous coronary intervention, coronary artery bypass grafting [CABG], optimal medical treatment).
- CABG was linked to higher event-free survival vs the other two.
Study design
- Analysis of single-center cohort data from a randomized clinical trial.
- 535 patients were randomly allocated to 1 of the 3 therapies.
- Outcome: composite of overall mortality, myocardial infarction, revascularization for refractory angina.
- Minimum follow-up for surviving participants was 10 years; maximum was 15 years.
- Funding: Zerbini Foundation.
Limitations
- Retrospective analysis.
- Medical therapy changed during the follow-up.
- Single center.
References
References
