{"id":22372,"date":"2025-08-24T16:08:34","date_gmt":"2025-08-24T20:08:34","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=22372"},"modified":"2025-09-17T16:13:05","modified_gmt":"2025-09-17T20:13:05","slug":"real-world-effectiveness-of-early-revascularization-in-stable-coronary-artery-disease-with-moderate-or-severe-ischemia","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/real-world-effectiveness-of-early-revascularization-in-stable-coronary-artery-disease-with-moderate-or-severe-ischemia\/","title":{"rendered":"Real-world effectiveness of early revascularization in stable coronary artery disease with moderate or severe ischemia"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Comparative effectiveness studies may provide insights into generalizability of the ISCHEMIA trial to real-world patients. We evaluated the long-term effectiveness of revascularization within 90 days after detecting moderate or severe ischemia on myocardial perfusion imaging (MPI) in stable coronary artery disease.<\/p>\n<p><strong>Methods<\/strong> \u2014 All consecutive patients with moderate or severe ischemia (summed difference score \u22657) on single photon emission computed tomography MPI at a tertiary academic medical center were included (January 2003 to March 2020). Early revascularization (defined as percutaneous coronary intervention or coronary artery bypass grafting within 90 days) after MPI, was compared to those patients treated without early revascularization, excluding those with left main disease, severe chronic kidney disease, severe left ventricular dysfunction, recent acute coronary syndrome or heart failure hospitalization. Primary outcomes were cardiovascular death or the composite of cardiovascular hospitalization or cardiovascular death, and were tracked throughout the provincial healthcare system.<\/p>\n<p><strong>Results<\/strong> \u2014 1530 patients (mean age: 65 years; 70 % male) were followed for a median of 9.9 years. After inverse-probability treatment weighting, early revascularization was associated with lower risks of cardiovascular death (3.76 % vs 8.93 %; HR 0.54, 95 % CI: 0.31\u20130.91, p = 0.022) and a reduction in the composite endpoint (33.73 % vs 43.94 %; HR 0.67, 95 % CI: 0.49\u20130.92, p = 0.013) compared to those treated without early revascularization.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Patients with stable coronary artery disease treated with early revascularization after MPI showing moderate or severe ischemia experienced lower risks of cardiovascular death and composite of cardiovascular hospitalization or cardiovascular death compared to those treated without early revascularization.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Comparative effectiveness studies may provide insights into generalizability of the ISCHEMIA trial to real-world patients. We evaluated the long-term effectiveness of revascularization within 90 days after detecting moderate or severe ischemia on myocardial perfusion imaging (MPI) in stable coronary artery disease. Methods \u2014 All consecutive patients with moderate or severe ischemia (summed difference [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,25],"migration-helper-qa-sample-set":[],"class_list":["post-22372","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-surgery"],"acf":{"citation":"Gerodias FJ, Iwanochko RM, Austin PC, Wang X, D\u017eav\u00edk V, Goodman SG, Udell JA, Ouzounian M, Ross HJ, Godoy LC, Amad H, Husain M, Lee DS. <em>Am Heart J Plus<\/em>. 2025; 58:100596. Epub 2025 Aug 24.","source_url":"https:\/\/doi.org\/10.1016\/j.ahjo.2025.100596","ices_scientist":[1385,1346,1290],"site":[6733],"research_program":[6742],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Real-world effectiveness of early revascularization in stable coronary artery disease with moderate or severe ischemia<\/title>\n<meta name=\"description\" content=\"Background \u2014 Comparative effectiveness studies may provide insights into generalizability of the ISCHEMIA trial to real-world patients. 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