The ISCHEMIA trial showed that in patients with stable angina and moderate to severe ischemia on stress testing, an invasive strategy coupled with optimal medical therapy (OMT) produces no benefit over OMT alone at the roughly three-year follow-up.

In a recent Cardiology article, Peter C. Block, MD, FACC, provides detail about the ins and outs of the trials, and notes that now both the COURAGE and ISCHEMIA trials imply that reducing myocardial ischemia may make you feel better, but does not affect other outcomes.

"Our challenge is not only to figure out whether one therapy is better than another, but also to identify those patients at the outset who will fail," writes Block. "Then we'll have to figure out newer, more effective treatments for them and see if the curves improve and move 'south.'" Read more.

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