The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Letter to the editor

Letter: Applicability of ISCHEMIA in real-world practice: where to START?

EuroIntervention 2021;17:e181-e182. DOI: 10.4244/EIJ-D-21-00018L

1. Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland; 2. Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
We read with great interest the recent publication by De Luca et al1 assessing the applicability of the ISCHEMIA trial to an Italian registry of more than 5,000 patients with stable coronary artery disease (SCAD). The authors found that only 3.8% of patients in this cohort were “ISCHEMIA-Like”, suggesting a very limited applicability of the trial to routine clinical practice. Furthermore, the authors found that “ISCHEMIA-Like” patients presented a significantly lower annual risk of adverse events compared to SCAD patients not eligible for ISCHEMIA.

Since its publication, ISCHEMIA has generated intense debate in the cardiology community. Two ...

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