ArticleJournal of the American College of Cardiology2023
Health Status and Clinical Outcomes in Older Adults With Chronic Coronary Disease: The ISCHEMIA Trial.
Article in Journal of the American College of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01471522 (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA)
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.Circulation. Cardiovascular imaging · 2025Pooled it
- The Effect of Age on Improvement in Health-Related Quality of Life After Percutaneous Coronary Intervention.Clinical cardiology · 2026Trial
- Invasive and medical management approaches to non-acute myocardial ischaemic syndromes.Nature reviews. Cardiology · 2026Review
- Heart Disease in Older Women: Unique Challenges in Diagnosis and Management.Current cardiology reports · 2026Review
- Characterizing heterogeneity in health-related quality of life trajectories in coronary artery disease: a longitudinal latent Markov analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- LncRNA HYMAI Promotes Endothelial Cell Autophagy via miR-19a-3p/ ATG14 to Attenuate the Progression of Coronary Atherosclerotic Disease.Current medicinal chemistry · 2026Article
- Hospitalizations for Major Cardiovascular Events in Patients Aged 75 Years or Older with Chronic Coronary Syndrome for the Whole Life Span.Journal of clinical medicine · 2025Article
- Coronary Artery Revascularization in the Older Adult Population: A Scientific Statement From the American Heart Association.Circulation · 2025Review
- Age and Health Status Benefits Following Initiation of Atrial Fibrillation-Specific Treatments.Journal of the American Heart Association · 2025Article
- Risk factors for prolonged hospitalization in acute decompensated heart failure from the HEROES study.Scientific reports · 2025Article
- Clinical practice patterns among older multimorbid adults presenting with suspected ischemic symptoms: A multi-center survey.American heart journal plus : cardiology research and practice · 2025Article
- Health status outcomes after acute myocardial infarction in patients without standard modifiable risk factors.American heart journal · 2025Article
- Chronic Coronary Disease in Older Adults.The Medical clinics of North America · 2024Review
- Chronological vs Biological Age in Interventional Cardiology: A Comprehensive Approach to Care for Older Adults: JACC Family Series.JACC. Cardiovascular interventions · 2024Review
- Imaging Advances in Heart Failure.Cardiac failure review · 2024Review
- Stable Coronary Artery Disease in the Age of Geriatric Cardiology.Journal of the American College of Cardiology · 2023Article
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29 authors at 14 institutions in 8 countries.
Funding
Abstract
backgroundWhether initial invasive management in older vs younger adults with chronic coronary disease and moderate or severe ischemia improves health status or clinical outcomes is unknown.
objectivesThe goal of this study was to examine the impact of age on health status and clinical outcomes with invasive vs conservative management in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial.
methodsOne-year angina-specific health status was assessed with the 7-item Seattle Angina Questionnaire (SAQ) (score range 0-100; higher scores indicate better health status). Cox proportional hazards models estimated the treatment effect of invasive vs conservative management as a function of age on the composite clinical outcome of cardiovascular death, myocardial infarction, or hospitalization for resuscitated cardiac arrest, unstable angina, or heart failure.
resultsAmong 4,617 participants, 2,239 (48.5%) were aged <65 years, 1,713 (37.1%) were aged 65 to 74 years, and 665 (14.4%) were aged ≥75 years. Baseline SAQ summary scores were lower in participants aged <65 years. Fully adjusted differences in 1-year SAQ summary scores (invasive minus conservative) were 4.90 (95% CI: 3.56-6.24) at age 55 years, 3.48 (95% CI: 2.40-4.57) at age 65 years, and 2.13 (95% CI: 0.75-3.51) at age 75 years (P
conclusionsOlder patients with chronic coronary disease and moderate or severe ischemia had consistent improvement in angina frequency but less improvement in angina-related health status with invasive management compared with younger patients. Invasive management was not associated with improved clinical outcomes in older or younger patients. (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches [ISCHEMIA]; NCT01471522).
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