The role of ISCHEMIA in stable ischemic heart disease.

Although it is well established that adding early revascularization to optimal medical therapy reduces mortality and recurrent myocardial infarction in acute coronary syndrome, there is less convincing evidence to guide intervention in stable ischemic heart disease. This review summarizes the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial, which investigated whether there is benefit from initial catheterization and possible revascularization in addition to optimal medical therapy in patients with at least moderate ischemia on stress testing.