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For more information on the main ISCHEMIA Trial, including trial results, please visit the ISCHEMIA Website.
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The ISCHEMIA-CKD Study Results are Available!
To view the results of the ISCHEMIA-CKD Study, go to: http://ischemia.nyumc.org/study-results
What is the ISCHEMIA-CKD study?
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The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches—Chronic Kidney Disease trial (ISCHEMIA-CKD) is an international comparative effectiveness study to determine the best way to manage stable ischemic heart disease in patients with advanced chronic kidney disease (eGFR <30 or on dialysis).
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Patients with advanced CKD and ischemia on stress test were eligible for participation
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The trial was designed to run seamlessly in parallel with the main ISCHEMIA trial
If you would like to hear more about the trial, please watch this brief video summary from the ISCHEMIA-CKD Principal Investigator.
Why is the ISCHEMIA-CKD study important?
More than 500 million adults worldwide have chronic kidney disease and this number is projected to rise with increasing prevalence of diabetes, obesity and the elderly. Among patients with CKD, cardiovascular disease is the leading cause of death, 15-30 times higher than the age-adjusted cardiovascular mortality rate in the general population and is worse than that for patients in the general population who have cancers, heart failure, stroke or heart attack. Participants with CKD are 5-10 times more likely to die than to reach end stage renal disease (ESRD) requiring dialysis. Despite this, ~80% of contemporary coronary artery disease trials exclude CKD participants. Most of the treatments aimed at reducing their cardiovascular events are therefore extrapolated from cohorts without CKD. Consequently, the optimal management approach to these patients is unknown.
This trial set out to inform clinicians and patients about a common question they encounter: when a patient with advanced chronic kidney disease has a abnormal cardiac stress test: is it better to do an invasive angiogram (take a picture of the heart arteries) with the intention of opening or bypassing any blockages with stents or surgery plus optimal medical therapy, or is it better to optimize medical therapy and only consider the angiogram with stents or surgery if symptoms cannot be controlled? The ISCHEMIA-CKD trial showed showed that heart procedures added to taking medicines and making lifestyle changes did not result in a reduced rate of heart attack or death compared with medicines and lifestyle changes alone. The trial also showed that heart procedures did not reduce symptoms appreciably or improve the quality of life compared with medicines and lifestyle changes alone. These results do not apply to people having a heart attack or those with severe chest pain symptoms.
If you are a physician and would like more information, please visit the For Physicians section.
