‘I have a narrowing in my heart artery and they don’t need to fix it?’ Impact of the ISCHEMIA trial

Avedis Ekmejian, Usaid Allahwala, RAVINAY BHINDI


© zephyr/spl
© zephyr/spl


The literature on invasive versus noninvasive treatments for stable angina has amassed, with significant implications for GPs and specialists alike. Both types of therapy have shown a reduction in morbidity associated with stable coronary artery disease; however, patient-tailored treatments should be guided by recent clinical trial evidence.

Key Points

  • There are a variety of treatment options for patients with stable angina, including invasive and noninvasive strategies.
  • Medical therapy targeting cardiovascular risk factors is the cornerstone of treatment of patients with coronary artery disease, and the GP has a central role in risk factor management.
  • Medical therapy should be optimised irrespective of whether an additional invasive approach is used.
  • Pharmacological therapy can be effective in controlling symptoms of stable angina.
  • In patients who have ongoing angina despite maximally tolerated pharmacological therapy, percutaneous coronary intervention (PCI) has an important role in relieving symptoms and potentially improving quality of life.
  • PCI is not offered for prognostic benefit in patients with stable angina.