ISCHEMIA Shared Decision-Making Tool
The ISCHEMIA trial was a large international randomized trial of patients with moderate to severe cardiac ischemia due to obstructive coronary artery disease who were randomized to either an invasive treatment strategy (coronary angiography and revascularization with stents or bypass surgery plus optimal medical therapy) or a conservative strategy of medications alone. On average, the invasive strategy did not prevent death or other clinical events, but did result in improved health status. While these differences represent “average” benefits, some patients improved more than others. This tool uses data from ISCHEMIA to estimate an individual’s quality of life, physical function and angina at 1 year and their survival at 4 years, based on their personal characteristics. These estimates are averages and are NOT guaranteed outcomes for specific individuals, but may be useful in discussions between patients and their doctors in choosing which treatment is best for that specific patient, based on their goals and values. Moreover, the ISCHEMIA trial excluded patients with acute coronary syndromes, left main disease and heart failure with reduced ejection fractions and these estimates do not apply to patients with these conditions