{
  "release_id": "f6f6f1b6f50379ed",
  "id": "cardio:ischemia-trial",
  "owner": "cardio",
  "kind": "study",
  "slug": "ischemia-trial",
  "name": "ISCHEMIA (initial invasive or conservative strategy for stable coronary disease)",
  "aliases": [
    "ISCHEMIA",
    "International Study of Comparative Health Effectiveness With Medical and Invasive Approaches"
  ],
  "atlases": [
    "cardio"
  ],
  "summary_plain": "A large trial of 5179 people with stable coronary disease and moderate or severe ischemia. Half were assigned to an invasive strategy (a heart catheter test, then a stent or bypass surgery when possible, plus medicines) and half to medicines alone, with a catheter test only if medicines failed. After a median of 3.2 years the invasive strategy had not reduced heart events or death.",
  "summary_technical": "Open-label randomized strategy trial (NCT01471522), 5179 participants enrolled, 2012-07 to 2019-06-30 primary completion, funded by the NHLBI among others. The abstract reports 318 primary events with the invasive strategy against 352 with the conservative strategy, a higher 6-month rate with the invasive strategy (5.3% against 3.4%) and a lower 5-year rate (16.4% against 18.2%, interval including zero), and says the findings depended on the definition of myocardial infarction. The registry names a study chair affiliated with New York University. The invasive arm covered PCI and coronary bypass, so the result is not about stents alone.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-14",
  "next_review_due": null,
  "identifiers": [
    {
      "scheme": "nct",
      "value": "NCT01471522",
      "normalized_value": "NCT01471522",
      "match": "exact",
      "version": null,
      "label": null,
      "from_source": false
    }
  ],
  "navigation": {
    "cardio": {
      "condition-area": [
        "coronary-and-vascular-disease"
      ]
    }
  },
  "payload": {
    "design": "Allocation: randomized. Intervention model: parallel. Masking: none. Primary purpose: treatment. (Registry values, in lower case.)",
    "drug_phase": "not_applicable",
    "registry_statuses": [
      {
        "status": "COMPLETED",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      }
    ],
    "start_date": {
      "date": "2012-07",
      "type": null,
      "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
    },
    "primary_completion_date": {
      "date": "2019-06-30",
      "type": "actual",
      "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
    },
    "completion_date": {
      "date": "2023-05-30",
      "type": "actual",
      "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
    },
    "results_first_posted": {
      "date": "2020-07-23",
      "type": "actual",
      "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
    },
    "countries": [
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        "code": "US",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "AR",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "AU",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "AT",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "BE",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "BR",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "CA",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "CN",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "EG",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "FR",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "DE",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "HU",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "IN",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "IL",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "IT",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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        "code": "JP",
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        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "NL",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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        "code": "NZ",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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        "code": "MK",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "PE",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "PL",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "PT",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "RO",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "RU",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "SA",
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      {
        "code": "RS",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "SG",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "ZA",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "ES",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
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      {
        "code": "SE",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "CH",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "TW",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
      {
        "code": "TH",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      },
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        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      }
    ],
    "care_setting": null,
    "stopped_early": null,
    "enrollment": [
      {
        "count": 5179,
        "basis": "enrolled",
        "unit": "participants",
        "snapshot": "cardio:ctgov-nct01471522-2026-10-14"
      }
    ],
    "arms": [
      {
        "id": "cardio:ischemia-trial-arm-1",
        "label": "Invasive Strategy (INV)",
        "intervention": null,
        "description": "Routine invasive strategy with cardiac catheterization followed by revascularization plus optimal medical therapy."
      },
      {
        "id": "cardio:ischemia-trial-arm-2",
        "label": "Conservative Strategy",
        "intervention": null,
        "description": "Optimal medical therapy with cardiac catheterization and revascularization reserved for patients with acute coronary syndrome, ischemic heart failure, resuscitated cardiac arrest or refractory symptoms."
      }
    ],
    "findings": []
  },
  "content_digest": "21ed5c8d63f419597af066711e90a62244fc8f791946c16fd028e9cf1f960097",
  "review": {
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    "current": [],
    "conflicting": [],
    "stale": [],
    "inactive": []
  },
  "claims": [],
  "decisions": [],
  "milestones": [],
  "relationships": {
    "outgoing": [
      {
        "predicate": "investigates",
        "label": "Lists percutaneous coronary intervention among its procedures",
        "clinical_claim_not_fact": false,
        "family": "sourced",
        "other_entity_id": "cardio:pci",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": {
          "snapshot_id": "cardio:ctgov-nct01471522-2026-10-14",
          "locator": "protocolSection.armsInterventionsModule.interventions[2].name"
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        "primary": false,
        "role": null,
        "valid_from": null,
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      {
        "predicate": "investigates",
        "label": "Lists coronary artery disease as a condition",
        "clinical_claim_not_fact": false,
        "family": "sourced",
        "other_entity_id": "cardio:coronary-artery-disease",
        "other_entity_in_atlas": true,
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        "evidence": {
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      {
        "predicate": "sponsored_by",
        "label": "Registry collaborator",
        "clinical_claim_not_fact": false,
        "family": "sourced",
        "other_entity_id": "cardio:nhlbi",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": {
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          "locator": "protocolSection.sponsorCollaboratorsModule.collaborators[2].name"
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        "primary": false,
        "role": "collaborator",
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      },
      {
        "predicate": "results_reported_in",
        "label": "Main results, NEJM 2020",
        "clinical_claim_not_fact": false,
        "family": "sourced",
        "other_entity_id": "cardio:pub-ischemia-nejm-2020",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": {
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          "locator": "Abstract, CONCLUSIONS, trailing note"
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    "incoming": []
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  "page_path": "studies/ischemia-trial/",
  "context_path": "api/v1/context/cardio--ischemia-trial.md"
}