14Apr 2022
Outcomes With Intermediate Left Main Disease: Analysis From the ISCHEMIA Trial

Outcomes With Intermediate Left Main Disease: Analysis From the ISCHEMIA Trial

Patients with significant (≥50%) left main disease (LMD) have a high risk of cardiovascular events, and guidelines recommend revascularization to improve survival. However, the impact of intermediate LMD (stenosis, 25%–49%) on outcomes is unclear. Among the 3699 participants who satisfied the inclusion criteria, 962 (26%) had intermediate LMD. In the ISCHEMIA trial, there was no meaningful heterogeneity of treatment benefit from an invasive strategy regardless of middle LMD status except for a more significant absolute risk reduction in nonprocedural MI with invasive management in those with intermediate LMD. An invasive strategy increased procedural MI, reduced nonprocedural MI, and improved angina-related quality of life.

  • #cardiology

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